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DANIEL MCBRIDE4223 W Grace St, Tampa FL 33607
813-872-2750Cell 813-503-1807
OBJECfIVETo obtain a position with a reputable company that will stimulate professional and personalgrowth by further development of new and challenging skills sets.
Summary
Became an Employee of Amerigroup Corporation which is the leader in Florida Medicaid in theQuality Management department. I adapted to the environment of the Medicaid community.Became fully trained in HEDIS administration as at temporary employee on January 31'120ll.Fully trained in HEDIS administration, such as medical record request for the HEDI NursingReview staff. Also fully trained medical record request and HIPP A. Subsequently trained all futureadministration temp employees during my full stay at Amerigroup. I came into full employmentafter nearly a year. Worked as an Outreach Associate, calling people regarding HEDIS measure tomaximize HEDIS scores. Then was transferred to the Grievance and appeals team in March 2012.Worked on grievances file from the Call Center to the complaints filed to government officials,such as the Agency of Health Care Administration to calls to the Governor. These complaintswere worked hand in hand with the Regulatory Department. Also, worked extremely closely withthe IRU Claims department. I also input Quality of Care issues for the nurses in the QualityManagement as well as inputting appeal requests and medical records requests for these issues.
Fully trained in the applications of Facets, Compass, Pega, CareCompass, Macess, Sharepoint,Aim
Personal AchievementsSolved the issues with Compass not sending mouth guards to children due to a failure in an Ad-hoc issuer task.Aided many people in solving issues with balance billing, authorization issues, obtainingmedication, getting necessary medical equipment. Helping these people was always a hugeaccomplishment
ReferencesLenora FisherLPNj Case Manager 813-898~3992Alice ScottIRUjClaim Specialist Retired 727-365-8U9Sylvia YanisGrievance and Appeals Coordinator 813-465-8919Tracy ParksQM Appeals Manager 727-687-8931
Employer: AmerigroupjAnthem Corporation4200 W Cypress StTampa FI 33607HR Representative Maritza 813-830-6946
Previous ExperiencePrevious Employment as Document and Imaging Specialist with over 10 years of experience
both at the clerical and supervisory levels. I have eleven years experience maintaining andcontrolling an Electronic Document Maintenance System application. Major strengths in peopleskills, organization, attention to detail, and exceptional judgment while working independently oras a team member.
PROFESSIONAL EXPERIENCESuncoast Schools Federal Credit Union) Tampa FL 1800-999-5887 Feb. 1999 - July 2010Imaging Specialist - Controlled all asped of the EDMS OnBase. Handled and created allprocesses, such as DIP, COF,COLD, TIP, and XMLdata transfer from the Data Center mainframe and the Item Processingsoftware of Metavante, Visa, and Fidelity. Maintained all five servers connected to the EDMS dailyfor complications and to correct the problems encountered In charge of all user group set upsand permissions and monitored the changes to all personnel changes, for example, terminationsand promotions. Responsible for resolving all technical issues for the system end user when issuesarose. Also created back-ups of all data to DVD and maintained the I pace on the file server.Accomplishments:• Successfully completed many major system upgrades with little or no complications• Reduced the number of reports that we no longer required by manually viewing all histories tofind defunct reportsto save time and reduce the strain of monthly and month end reports to the mainframe• Handled over 200 workflows I• Created many new statement files and reports that were not generated within house but fromoutside sources I• Fixed all user issues and reported any bugs to Hyland software byl gather all information fromthe application• Met with Departments and designed the needs they had for the work flow creations to speed upand create a moreorganized department• Developed OCR and scanning for the many documents in addition to creating all documentsthat need to be scannedEDUCATIONGraduated in 1988 from Swartz Creek High School. Various training courses at Suncoast throughCUNA as well as theEDMS websites to keep current with the application's changes and needs for the work force.SKILLS IASSETS• Proficient in all Windows platforms
Fax Server2/1/2016 4:14:59 PM PAGE
February 1, 2016
To Whom It May Concern:
I am pleased to write a letter of recommendation for Daniel McBride.
I've known Daniel for many years and am grateful to him for our friendship. He hasmany years of experience in the insurance industry and has represented his position in aprofessional manner. I'm a nurse case manager and have worked closely with Daniel inresolving member grievances; it was very rewarding to assist Daniel with his efforts.
I highly recommend Daniel for any endeavor he pursues. I do believe with Daniel'sknowledge of the health care industry, his interpersonal skills, abilities, and his pursuit ofexcellence, he will surpass your expectations and give the results you are looking for withintegrity.
Feel free to contact me using the information below if more information is needed.
Sincerely,
Lenora Fisher, RN/[email protected]