Blyth Gurule Email & Phone Number

San Francisco Bay Area

This position is responsible for reviewing and analyzing departmental processes and systems. Other responsibilities include ensuring process quality and integrity and reviewing workflow tasks. The results of this analysis are documented, tracked, and reported to internal and senior management to gauge factors such as customer satisfaction, timeliness of processes, contractual requirement adherence and other requirements as defined. Conducts audit and review of records, system set up, procedural accuracy and quality standards and workflow tasks. Conducts investigations and supports in complying with requests from enforcement agencies and assists in special investigations, as needed. Participates in the identification of training needs and training for staff to improve the quality and accuracy of the work performed. Edits and/or creates policies and procedures for quality review functions and tasks. Reviews all the information in the processing systems, benefit details within benefit packages and contractual documents, relating to the evaluation process. Conducts random samples of group’s documents to ensure they meet the quality guidelines of the work output of the Quality Assurance department. Conducts review in the processing systems and benefit details within benefit packages for high-profile groups and groups with special requirements to ensure these group specific guidelines are being met. Reviews the group or benefit set-up for a high volume of groups as a result of new state laws or regulations that mandate an update for certain group types. Validates/verifies new processes for Implementation before it is loaded in the processing system. Creates, reviews and analyzes various reports and procedural data to ensure accuracy. Performs miscellaneous duties as assigned.

San Francisco Bay Area

Professional ExperienceDelta Dental of California-San Francisco, CA PresentGroup Configuration Specialist Assists in running the Group Configuration department at a company with over 74 million enrollees.• Setting up the groups information’s; analyzing and validating contracts and processing/ updating information in multiple internal insurance systems in a timely and efficient manner• Analyzing changes request to ensure accuracy and contract compliance prior; updating impacted business systems and communicating actions required• Resolving billing contract update/ issues; escalating irresolvable workflow or processing issues to appropriate management staff; performing miscellaneous duties as assigned• Work with the Sales team extensively to make sure all information given to billing is correct and that there will be no delay to the client’s • Maintained the monthly subsidy report and detailed the discrepancies to the Account Receivable department• Helped with reconciling group invoices• Have experience working with sensitive information and up to date on HIPPA laws

Delta Dental of California-San Francisco, CA 2009-2012Quality Assurance AnalystCross checked enrollment and billing issues for inaccuracies within customer and business records. • Track errors and report them to various departments and managers. Checking abstracts from Atlanta, Pennsylvania, and California including small business groups for errors, within the information given• Maintained numerous excel spreadsheets for several different locations logging various groups’ information that are sent to the Group Records Department. ID card batch reports and updating a monthly spreadsheet tracking the process for special groups• Co-Wrote and created edited the Billing QA step by step guide

San Francisco Bay Area

Various admin duties for several different companies including:Paragon Real Estate, Wild Planet Toy’s, KCBS Radio, and Ellen Magnin NewmanData EntryMaintained multi- lined phone systems Support the real estate agents on various taskProvided dictation transcription Verified that client’s information in the computer system was accurate and up to dateProvided dictation transcription

San Francisco Bay Area

Administrative Assistant for a marketing research company. • General office and front desk coordinator for a marketing research companyHelped with various admin duties, from Director to helping research clients Managed conference room calendaringMonitored and maintained inventory of supplies used by the companyMaintained multi-lined phone systemHelped plan and run company events such social gatherings for the purpose of building morale and creating company cultureOrganized billing and data invoices for clientsVerified that client’s information in the computer system was accurate and up to dateGreet clients, visitors, including VIPs, and vendors