Nancy Hicks Email & Phone Number

Yulee, Fl, Us

Jacksonville, Florida, United States

Jacksonville, Florida

As a member of the Payment Accuracy and Improvement Team, I support claim payment accuracy through an intense focus on mitigating claim mis-payments by supplying the necessary data and reporting for core team functions. Develop programs to access large amounts of data from various systems and databases. Use SAS to analyze and structure datasets into a more consumable format to be used for issue research, issue impacts and savings estimates, post-implementation validated savings and ad-hoc data requests.

Jacksonville, Florida Area

Lead projects to reduce cost and increase efficiency for the Enterprise. Perform data analysis using SAS and SQL language in order to support recommendations made to business area stakeholders. Build rapport with various levels of leadership throughout the Enterprise. Serve as a liaison between IT business partners and business area when needed to facilitate project implementation. Provide coaching and training as part of coworker onboarding. Frequently pull data from FL Blue data tables from various databases. Assist colleagues within the organization in writing queries and navigating the data tables.

Frequently utilize SQL Navigator to develop and produce daily and adhoc reporting for leadership of all levels within the Service Organization. Query and analyze data to identify root causes and/or trends. Perform research and critical analyses to draw relevant conclusions. Present conclusions and recommendations for use in decision making. Tailor presented data analysis in a manner that is clear and understandable by the intended audience. Prepare studies of business conditions and trends to draw relevant conclusions. Interpret report results and provide alternative recommendations to upper leadership and/or business partners for further consideration. Provide Subject Matter Expertise representing SO Claims for projects and implementations. Develop communications for front-line staff providing updates/reminders on polices/processing guidelines. Support and lead continuous improvement, quality improvement and process improvement activities for SO Claims. Coach, mentor, and provide support to other Analysts and front-line staff as needed. Provide SO Claims representation in cross-functional projects/meetings with internal and external business partners.

Identify, research, analyze and recommend process improvements to existing business processes. Provide leadership and technical expertise for the planning, managing and implementation of process improvements. Provide consultative assistance to Service Organization teams and leadership on requirements for data analysis, trends and adhoc reporting. Frequently utilize SQL Navigator to develop and produce daily and adhoc reporting for business needs. Monitor Departmental Performance Scorecard and research areas where performance can be improved. Present comprehensive Executive summaries for leadership to use in making business decisions for process improvements. Present data analysis findings and recommend solutions and/or improvements to the process.

Jacksonville, Florida Area

Monitor, analyze and trend open aging claims inventory. Ensured target or above target performance scores for departmental metrics. Coordinate with both internal external stakeholders to ensure business success. Accountable for resolution of incoming and outgoing escalated claims issues with sister Blues plans. Negotiate alternative issue resolution with stakeholders. Serve as subject matter expert for internal departments with regards to BlueCard procedures and BCBS Association policies. Actively engage in IT Operational Impact meetings to ensure scheduled maintenance and system enhancements align with policies and do not interrupt business process. Present information to multiple levels of leadership throughout the company. Develop and maintain service level agreements, desktop reference procedures, and other documents for departmental use. Provided interim Senior Analyst support to Critical Inquiries Department assisting with member and provider escalated inquiries, Department of Insurance Regulations inquiries, Department of Financial Services Inquiries, etc.

Jacksonville, Fl

Responsible for data entry and processing medical claims. Assist with training and auditing of new employees. Supported other teams with backlogged inventory in order to meet departmental goals.Identify trending and make suggestions for improvements. Provide leadership to team by facilitating TWC meetings and coordinating team activities. Successfully completed Six Sigma e-yellow belt training.Provide technical support and guidance to a team of Service Advocates. Utilize inventory system to report daily inventory volumes to leadership team. Coordinate workflow to ensure claims are processed ethically and efficiently. Act as an informal leader by performing limited management duties while the immediate manager is unavailable. Communicate with Operation Analysts prior to and following system implementations to ensure normal process is not interrupted. Serve as a Subject Matter Expert regarding BlueCard claims. Worked on a Rapid Process Improvement project focused on reducing administrative costs.