Robert Balcom Email & Phone Number

Jacksonville, Florida

Jacksonville, Florida Area

• Accountable for communicating complex analytic information to designated stakeholders.
• Responsible for writing complex and unique queries to supports sales in client retention and analysis.
• Work on cross-functional teams both internally and externally in development, implementation and execution of corporate and group specific initiatives (ICD-10, Care Outcomes, and Finance Initiatives).
• Analyze and communicate the effectiveness of benefit programs, clinical programs, and CARE management programs in an effort to communicate Florida Blue integrated value proposition.
• Perform analysis using medical, behavioral health, financial, benefit and pharmacy data to identify ideas for clients to improve the health, well-being, and financial situation of their membership and/or group.
• Responsible for creating effective analytic processes that enhance BCBSFL ability to message program and benefit efficacy.

Jacksonville, Florida Area

• Responsible for compiling, analyzing, billing and reconciling approximately ninety five million dollars in ASOII and MPP (self-insured plans) claims each month.
• Work closely with IT to identify root causes of claims reporting errors while seeking to eliminate those issues and improve process resolution.
• Manages all BCBSFL ASOII/MPP accounts, workflow and information requests; requiring in depth knowledge of corporate products, systems and operational procedures originating from both internal and external customers.
• Provide detailed reports and claims analysis, along with ad-hoc projects, and workflow streamlining to include interpreting information from other technical areas, supporting overall performance against known.
• Assist in design and testing multiple parts of MBI / ASR including ASOII and MPP claims and stop loss graphical user interfaces.
• Effectively understands and applies policies, processes, procedures and follows HIPAA guidelines as required by law.

Jacksonville, Florida Area

• Served as the technical expert for large group self-billing.
• Created and implemented the self-billing process for National Corporate and provided training of other Geographical Business Units to utilize the same process.
• Facilitated individual evaluations, in addition to training sessions for the following: policies and procedures, Excel, PowerPoint and Self-billing reconciliation problem-solving, along with TWC’s, position feedback.
• Provided ongoing support for Excel and Self-billing after being promoted and leaving the department.

As Network Systems Technology, Information Technology Analysis, 3.9

Education record