Reference Data Maintenance - Manager Resume Example

• Manage a team of 15 professionals.
• Supervise effective working of production personnel and prepare effective production schedules and ensure compliance to all company policies.
• Interviewed trained and assigned positions to new hires.
• Supported various business processes in a timely manner while ensuring quality.
• Prepare vacation schedule for all employees maintaining continuous production.
• Attend and provide input for work area at internal/external meetings.
• Ensure compliance to all local policies to achieve all production objectives and provide appropriate feedback to all employees.
• Responded to customer State Action Request (SAR).
• Provided pertinent productivity data to leadership for projections and budgets.

NOTE: Supervisor from March 2013 - July 2014 under XEROX/ACS STATE HEALTHCARE

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• Perform updates on data records to Compass 21 (C21) system by building data sheet(s) using microsoft excel.
• Maintained team's policies and procedures and work instructions.
• Perform extensive research and analysis on C21 system to assist client in developing policies.
• Respond to and complete State Action Request (SAR) initiated by State customers.
• Provided staff from other internal departments with expertise analysis to help with resolving issues related to C21 system.
• Developed training guidelines to train new and existing employees.
• Conduct and attend workgroup meeting(s) providing expertise input for work area.
• Monitored project progress and addressed client issues.
• Developed and implemented test plans and user acceptance testing (UAT) to ensure project accuracy.
• Lead and coordinated major projects such as Annual ICD and Annual HCPCS.

• Back up to leadership when needed. 
• Trained new employees on the C21 Claims processing system to ensure claims are processed accurately and timely.
• Responsible for meeting the required performance standards for productivity and quality as established by the immediate leadership and approved by department manager.
• Maintained up-to-date knowledge of the Medicaid billing procedures and policy.
• Assisted peers within the department with complex issues and questions.
• Prepared and provided daily production reports to leadership.
• Assisted other departments with research questions concerning billing issues.
• Knowledge in over 100 edits and audits.

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• Proficient in adjudicating professional and outpatient claims in Compass 21 (C21) System & MMIS (Medicaid Management Informational System).
• Maintained team inventory in a timely manner.
• Keyed in pre-system (batches not yet keyed into system).
• Knowledge in over 50 edits and audits.
• Successfully trained in back end and front end claims processing.
• Assisted customer service with questions concerning claims.