Alex Foley Email & Phone Number

o Provide pre and post-sales application demonstrations to external stakeholders to illustrate the value proposition while uncovering clients’ needs to provide solutions that fit their business modelo Ensure business requirements are valid, clear, and concise by asking probing questions to produce an easily understood technical translation through Jira.

o Assure product quality through the development and execution of manual test scripts while adhering to department's cadence and accuracy guidelineso Support root cause analysis and communicate proposed solutions in an effective and timely manner to key stakeholderso Execute assigned application regression testing on a weekly basiso Participate in weekly.

o Manage vendor and cross-functional business relationships to develop, test, and implement new and upgraded solutions for online provider directory and cost estimator toolo Analyze, review, and resolve issues related to online provider directory and cost calculations o Conduct, organize, and schedule project meetings, document minutes, and drive next.

o Adjudicate and manage high and low volume claim adjustment recoveries, high dollar claims, and validate DRG-priced facility claims o Promote accountability and adherence by maintaining availability for the Interplan Hotline, field incoming calls from internal/external customers, and ensure follow-up in a timely mannero Train associates on adjudication of.

Hingham, MA

o Utilize various applications to correct erroneously processed professional and facility claimso Initiate and respond to claims correspondence with fellow Blue Cross Blue Shield Association planso Apply fast-paced critical decision-making skills for each interaction with a provider or sister-plano Assist in training newly hired associates

o Provide benefit and eligibility information of members to dental providers nationwideo Maintain a working knowledge of ADA procedure codes and regulations

o Correct information, when necessary, on erroneously scanned claims

Bachelor Of Science - Bs, Management Information Systems, Technology And Management

Associates, Business

Associate Of Arts And Sciences (A.A.S.), Recording Arts Technology/Technician