Anna G. Email & Phone Number

Providence, Rhode Island, United States

• Responsible for a full range of activities that ensure the overall effectiveness and excellence of RIQI’s core functions and services. With a focus on product support and process improvements that involve the design.
• Perform task work needed to document operational processes and procedures for newand existing products and services.
• Perform analysis work and making recommendations to improve specific… Show more Responsible for a full range of activities that ensure the overall effectiveness and excellence of RIQI’s core functions and services..
• Perform analysis work and making recommendations to improve specific operationalwork processes.
• Provide analytical support for the rollout of new features and improvements for variousproducts and services.
• Reporting for the RHIO state deliverables and department monthly metrics. Show less

Providence, Rhode Island Area

• Assisted the Director and department manager in designing business processes and operational workflows for the CurrentCare, CurrentCare for Me, Care Management and Statewide Provider Directory products.
• Subject Matter Expert (SME) on the Care Management Panel process
• Analyze files submitted by our data sharing partners for upload to our product databases.
• Reporting for the Operations monthly metrics and CurrentCare Enrollment quarterly presentation
• Train staff on new… Show more Assisted the Director and department manager in designing business processes and operational workflows for the CurrentCare, CurrentCare for Me, Care Management and Statewide Provider.
• Train staff on new and updated products to ensure consistent processing within the department.

Providence, Rhode Island Area

Accepted into the Tech Force Rhode Island grant program. Attended career workshops to work on my resume and job interview skills.

Providence, Rhode Island Area

• Previously Perot Systems, Dell acquired this division in 2009.Analyzed and tested policy and benefit system changes for the Blue Cross Blue Shield of Rhode Island account. Maintained the “orbit” report consisting of.
• Led the “orbit” report team in researching, identifying and reporting unpaid claims for clients. The report claim… Show more Previously Perot Systems, Dell acquired this division in 2009.Analyzed and tested policy and.
• Led the “orbit” report team in researching, identifying and reporting unpaid claims for clients. The report claim count reduced from 1600 to 0.
• Lead tester for the Blue Cross Blue Shield of Rhode Island’s CVS account. Created and ran the testing for the annual benefit updates and audit.
• Identified a major project issue with system coding prior to production that saved countless hours of additional claim adjustments.
• Created an Excel testing spreadsheet and several Word templates to aide team in reducing the test create time by 50%.

Providence, Rhode Island Area

• BCBSRI’s claim division of Rhode Island. Outsourced to Perot Systems in 2003Promoted to job after completion of the Health Insurance Portability and Accountability Act (HIPAA) project.
• Assigned to the HIPAA project which led to the promotion to the Business Analysis team.

Providence, Rhode Island Area

• Led several different teams with training, answering questions and quality control of work. Assigned to negotiate discounts with out-of-state non-participating hospitals. Researched and adjusted restricted employee’s.
• Negotiated with out-of-state hospitals for direct reimbursement resulting in reducing the subscriber's out of pocket costs and saving the company over $1M.
• Led a team of up to 23 employees by… Show more Led several different teams with training, answering questions and quality control of work. Assigned to negotiate discounts with out-of-state non-participating hospitals..
• Led a team of up to 23 employees by instructing training sessions, answering questions and quality controlling of work. Many of these employees received promotions.
• Created a hospital pricing training document to distribute company-wide saving countless hours of adjustments on incorrect manual paid claims. Show less

Providence, Rhode Island Area

• Achieved known status as being the “go-to” person for questions regarding benefits and processing of claims. Performed claims entry, adjustments and manual processing of hospital, professional and pharmacy claims.
• Identified a participating provider billing error on a subscriber’s submitted receipt that improved the future billing process for future subscribers.