vendor manager

community representative

accounting manager

accountant

community nurse

Excellus BlueCross BlueShield

Susan Dangler										Summary:	Seeking administrative position in a corporate environment utilizing claims processing, clerical, and customer service skills.

Skills:			Proficient in AS400, LRSP, Microsoft Word and Excel, Lotus Notes
Strong Keyboarding skills including 10 key numeric entry (55wpm)
Strong attention to detail with strict adherence to company protocols
Excellent customer service to providers and service members
Highly organized, strong written and verbal communication skills.	

Experience:		Office Clerk, Frontier Communications			03/2012-Present
•	Process customer payments
•	Research payments with DPI system
•	Open and sort incoming payments on the Opex Manual machine.
•	Key customer payment into TMS.
Claims Processor, Rochester Laborer’s			05/2011-12/2011
•	Responsible for cost calculations for emergency room visits
•	Processed and prepared medical claims documentation
•	Managed all clerical aspects, faxing, filing, electronic reporting, documentation
•	Customer Service, determined claims status and eligibility, worked closely with insurance providers and union members
•	Written correspondence to providers and members
•	Daily data backup
Claims Processor, Excellus Blue Cross Blue Shield	12/1992-07/2010
•	Verified inpatient claims in accordance to corporate policy
•	Accurately input and updated medical documents from physicians, hospitals, insurance companies, and vendors in a timely manner
•	Researched and confirmed required information for claims completion
•	Performed all duties with strict adherence to HIPPA regulations
•	Followed procedural guidelines in all aspects of work

Education:		Office Technology Career Certificate, Greece Community Education, 2011
			National Professional Customer Service Certificate, National Retail Federation
			Monroe Community College Business Law and English 101 completed.

I did learn a lot there.  I did UM for 10 yrs then the other 10 1/2 I was 
a benefit specialist , referred members to other areas that had chronic illnesses .  I also took care of updating info, doing referrals, for sick babies. Calling Dr. offices, keeping a spread sheet , for the nurses, for review of Synagis for sick babies.

Also called hospitals for reviews, discharge dates .

The hardest part of the job was ,that my supervisor had favorites, and would have them spy on me, with what I was doing, and any mistakes I made. 

I worked hard there. I came in early , I was there for over 21 1/2 yrs .
My job was eliminated ,when wellpoint bought them . I was put into a different position ,needed more training , they said no . By then I was not sleeping , was on anxiety medicine.

I wanted to apply for other jobs ,they would not let me . The hardest part of the job ,was being respectful to people , who treated me very mean.  Then they said after all these years, of coming in early ,(not getting paid for it )  They asked me ,if I wanted to leave with my head held high,and quit .

I explained, that I was proud of my yrs there. I worked hard . Enjoyed my job, bout I am 57 yrs old, and needed my unemployment .

Overall, Excellus is a very good place to work.  I am in customer care, and the breaks and time off are very reasonable.  The managers give you coaching or correction when it's needed, but it's always done professionally.  The workplace is very respective of other cultures and backgrounds. The work itself can a bit stressful on a busy day, but rarely  overwhelming.  There are good benefits, including good health care, dental, and a pension plan, and the compensation is fair for customer service.  You certainly get to help people.  I've helped a number of elderly people get their medical claim problems taken care of, and they really appreciate it.  As with any customer service job, you'll have some people on the line who are rude, but for the most part the work is pretty pleasant.  The company is a big part of the community I'm in, helping not for profits, and working to solve problems in the area.  The regional director is a very visible community leader people here really respect. No job or workplace is perfect, but overall, it's a solid company I'm proud to work for.

Overall the experience at Excellus is favorable, but has definitely been a struggle at times. The HR onboarding is smooth and cohesive, but the technical onboarding leaves much to be desired. Many of the systems here have been tailored exclusively for Excellus' use over the years and it takes a long time to familiarize yourself with their workings (especially if you come from an industry not related to healthcare - this industry is complex just on its own, let alone adding in the proprietary systems and processes that have been deployed at Excellus to help meet guidelines and goals).
Prepare for a little "drinking from the firehose" while you learn on the job....a job which can encroach into your free time, especially during the busy time of open-enrollment.

The company does do a good job of making sure compensation is appropriate and that you have easy access to management for all types of communication however.

Excellus underpays by 20-25% and has a 1970s mgt style.  They treat employees like commodities and that is why people leave.  Those who stay undervalue themselves and mgt. likes it that way.  Until or unless they remove the deadweight from sr. mgt. (eg: VPs with literally 6 ppl working for them!) as well as retire the dinosaurs they have running divisions that desperately need fresh leadership, they will continue to stagnate.

They are losing members in a market where ppl are REQUIRED to buy health insurance.  Bad mgt. and poor employee relations are much of the reason.

Still, Excellus has the best health insurance in the area.  The mgt. deadweight and waste however keeps costs up, so keeping premiums higher than other companies', thus costing them members.  Three words: Business Process Reengineering.  Desperately needed.  Start by dumping half your VPs.

The CIO has taken to bringing in cheap IT contractors from India (Cognizant) because the ordinary way to get new IT blood is hamstrung from above.  Booth is the main culprit overseeing this stagnation and waste.  The B of D needs to tell him to stop treating this as a retirement job and get serious... or get out.

If you're looking to grow within your career, Excellus isn't the place to do it.

Management is poor; they shift a lot of management tasks onto staff.

I was removed from work as a result of medical reasons and in the process of recovering they "Back Filled" my position. They were provided notice that I would be returning in the near future and that I wanted to establish a return to work plan (addressing some concerns before I returned). HR acknowledged my questions and when they finally provided a reply, they informed me that my position was "Back Filled". A health insurance company should value their employees and their health, Excellus fails to offer this.

Within my department there was a large amount of employee turnover as a result of the poor management. HR has failed to fix the problems within the department,even though staff members clearly communicated concerns of management, my employers neglect exposed me to a toxic work environment.

Working as Customer Advocate and Claims Processor at Empire BlueCross and BlueShield one is faced with a very fast paced, stressful environment in which there were very limited opportunities for upward mobility. This is an organization where one moves up by currying favor with their boss.   I did my job well but was only able to move laterally. Annual raises are 3% at best.  The stress of meeting quotas for productivity and quality was abated somewhat during the years I worked under good managers who were willing to advocate on behalf of us to upper management. Good managers listened when we explained that we were not able to take over 12 calls per hour when people called regarding multiple claims and were able to have the quota reduced. I really stayed there so long because of the excellent benefits and acquiring 30 days paid time off.   I left there because of a supervisor who was authoritarian and inflexible.

As a Customer Service Representative, I was allowed one hour to review, make any call backs to the providers and subscribers, and possibly resolve any previous days work before signing
on the phone line. This also included processing of any problem claims. 
   
     Excellus Blue Cross Blue Shield BS was a great company to work for. The management staff was very professional and caring. My co-workers were respectful of others around them, some of us became the best of friends. We all worked together to achieve a common goal. 

   I've learned over the years that everyone matters, that it is very important to empathize with others, because we all have a story. I enjoyed corresponding with the healthcare providers as well as the subscriber. It gave me a great deal of pleasure to know that my job performance caused the customer to be satisfied.

Excellus BlueCross BlueShield was a great place to work.  There was a great management base and always made sure the staff enjoyed their work day.  We had many amenities such as a great work out room, wonderful cafeteria and many wellness and educational fairs throughout the year.  The management always made sure the staff was well taken care of and enjoyed their job at the corporate level as well as the departmental level.  I enjoyed working there every day.  It was very fast paced which I enjoyed. We had various projects that I participated in to better process flows and claims processing.  I enjoyed all of the meetings I was a part of to better the workflows and organization.  We had various staff and corporate meetings to make us aware of the environment.  I would recommend Excellus to anyone in Syracuse as they are truly a great place to work.

Customer Care Advocate...sounds great right?  WRONG! I have worked in many call centers over the course of many years, this is by far the most demanding - with the lowest pay. You will be told over and over and over how important you are to the company, however, you are the LEAST paid.  You will have to learn about all the different plans, all the ins and outs of claims,  as well as follow their protocol to the letter. All of your phone calls will be recorded and then reviewed by multiple different layers of management. You will then be graded on the calls that they chose to listen to.  It is constant scrutiny and constant pressure, the calls come right in via a headset and they are one right after each other. Under no circumstances will you feel valued.  There are some amazing managers and the rest, if they are ever actually in the office, are subpar. My advice... RUN ...don't walk .....RUN.....

Top Job Titles	Average Salary
Vendor manager 1 salary reported	$72,500 per year
Community representative 5 salaries reported	$23.99 per hour
Accounting manager 3 salaries reported	$107,500 per year
Accountant 3 salaries reported	$70,000 per year
Community nurse 1 salary reported	$83,670 per year

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