THEODORE HISEY

W. Swann Ave Tampa,FL33609

(813) 376-2809
th569ebc@westpost.net
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CAREER OBJECTIVE
Results-driven Business specialist eager to contribute superior analytical, prob
lem-solving and customer service skills toward supporting the employer in optimi
zing operational and financial performance
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PROFILE
* Offer solid, progressive Information Technology experience, with expertise in
project planning and implementation, systems development, issue resolution, and
client relations
* Successfully assess and respond to client-specific needs; define and document
requirements, create and execute project work plans, complete systems testing, p
rovide user training, and deliver solutions on time and within budget
* Serve as Subject Matter Expert on federal and state guidelines for Medicare an
d Medicaid claims and enrollment submission requirements; strong practical knowl
edge of PPO, POS, and HMO business lines
* Effectively provide Help Desk assistance, as well as exceptional business deve
lopment, sales, marketing, public relations, and operational support
* Excellent record of boosting financial performance by improving efficiency, pr
oductivity, and accuracy; negotiate vendor contracts to increase corporate profi
tability
* Dynamic communication, presentation, negotiation, and relationship management
skills; demonstrated ability build and retain diverse client base
* Proactive team player equally effective in independent and collaborative envir
onments
* Bilingual in English and Italian with translation/interpreting experience
~ KEY ACHIEVEMENTS ~
* Played an integral role in automating health insurance claims Appeals and Grie
vances process resulting in increased efficiency and accuracy, as well as cost s
avings, for multiple lines of business with SunGard; successfully designed proce
sses to capture medical records, provider demographic data, contracts, and crede
ntialing data
* Applied healthcare industry best practices and strong project management skill
s towards developing an automated Medicare Enrollment process for SunGard
* Worked closely with Access Health Systems providers to continually improve ser
vice levels and control costs; negotiated contracts and service terms, facilitat
ed claims payment, investigated and resolved issues, and ensured procedural inte
grity
* Performed a range of operational functions for Access; teamed with interdepart
mental personnel to conduct contract reviews, prepared and submitted claims inve
ntory and customer service activity reports, and reconciled client eligibility d
ata
* Generated $239K in new revenue, acquired more than 40 new clients, maintained
outstanding levels of customer satisfaction, and consistently achieved sales goa
ls as an Account Executive with Market Wire
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EDUCATION
Master's Certification in Project Management, Villanova University
Bachelor of Science, Political Science, Florida State University, Tallahassee, F
L 2005
* Quadruple Minors, Florence, Italy (2002 - 2003)
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PROFESSIONAL EXPERIENCE
Systems Analyst, Implementation Team, SunGard Corporation, Birmingham, AL 7
/08 - Present
Account Manager, Madrona Corporation, San Antonio, TX 9/06 - 6/08
Account Executive, Market Wire, Tampa, FL 7/05 - 9/06
Provider Relations Representative, Access Health Systems, Nashville, TN 9
/97 - 7/99
Customer Service Representative, Signature Health Plan, Nashville, TN 5/97
- 9/97
Intern, United HealthCare Group, Minneapolis, MN Summer 1996