1. ONETTE D. ALLEN SENIOR-LEVEL INSURANCE
ADMINISTRATOR
J
Visionary ~ Business Development ~ Due Diligence ~ HealthCare Insurance
Entrepreneurial, innovative Supervisor with over fifteen years’ extensive experience within the health care
insurance industry and maintaining proven success in streamlining procedures and maximizing departmental
efficiency. Analytical strategist skilled in utilizing effective business strategies and achieving cost containment.
Collaborative communicator continually focused on building relationships and promoting synergy across business
lines and global units to drive positive change, cohesive, comprehensive business approaches and enhanced cost
savings. Areas of Expertise include:
Strategic Planning & Forecasting Quality Assurance Insurance
CMS/NCQA Regulatory Guidelines Relationship Building Project Management
Microsoft Office/Windows Vista
Oracle
FullShot/SharePoint
Staff Training & Leadership
Customer Relations
Claims Processing
Problem Resolution
Member Appeals Systems
Adobe Pro
EXPERIENCE & NOTABLE CONTRIBUTIONS
INDEPENDENCE BLUE CROSS – MEMBER APPEALS ADMINISTRATION • Philadelphia, PA • 2003-Present
SUPERVISOR (2012-PRESENT)
Develop and implement strategic desk line procedures to improve performance and production with a keen focus
on raising standards of operations and exceptional client services. Supervise and mentor 19-member team in day-
to-day appeal for front end operations. Create direct reports and manage incoming appeal inventory.
CONTRIBUTIONS & PROCESS DEVELOPMENT:
•Serve as Subject Matter Expert for Appeals in Blue Core Transformation and Appeals Department Liaison for
internal customers.
•Conduct quality assurance and compliance audits.
TEAM LEADER/QUALITY ASSURANCE ANALYST (2006-2012)
Reviewed daily reports and quality trends for quality assurance and provided technical support to
administration area. Supervised, mentored and trained new staff on departmental procedures and maintained
attendance and production records. Collaborated with management to conduct procedure reviews and
develop new policies. Reviewed case files daily for appeal identification.
CONTRIBUTIONS & PROCESS DEVELOPMENT:
• Independently ensured files were compliant under established policies and procedures.
• Monitored all correspondence for compliance with federal regulations.
TRIAGE SPECIALIST (2003-2006)
Received incoming telephone calls from internal and external customers of IBC Family of Companies and
conducted outreach calls to members and providers. Reviewed incoming appeal requests and identified and
corrected errors on appeals files. Identified group contract claims fiduciary status and prepared member appeals
files for investigation.
ASSOCIATE OF ARTS, HEALTHCARE MANAGEMENT
COMMUNITY COLLEGE OF PHILADELPHIA | Philadelphia, PA | 2010
PHILADELPHIA HIGH SCHOOL FOR GIRLS | Philadelphia, PA | 1995
Furnished Upon Request
1266 South Bonsall Street  Philadelphia, PA 19146  215.888.4603  joal1116@aol.com
EDUCATION
REFERENCES