1. KELLY L. DANIAS
437 CADDIS CREEK ROAD | IRMO, SC 29063 | KELLYDANIAS@YAHOO.COM | 803-429-8591
QUALIFICATIONS PROFILE
HEALTHCARE EDUCATOR with 15+ years of experience supporting the mission of major insurance
carriers, healthcare non-profits and physician professional associations. Highly effective in conducting
in-service training for physicians and healthcare professionals and developing comprehensive website
content using expertise in Medicare. Adept in recruiting physicians for professional membership
organization and serving as an advocate for timely and accurate insurance reimbursement.
Key Strengths:
 Dynamic public speaker with experience addressing a variety of issues for diverse audiences.
 Excellent project manager who transforms strategic plans into successful solutions.
 Well-versed on Medicaid and Medicare provisions and regulations.
PROFESSIONAL EXPERIENCE
THE LEUKEMIA & LYMPHOMA SOCIETY (LLS), SC CHAPTER, Columbia, SC, 6/2013 – 6/2015
Patient Access Manager
Connected blood cancer patients with LLS core services soon after diagnosis by conducting face-to-face
visits with physicians, nurses, social workers and other health-care professionals at cancer centers and
community oncology practices to obtain referrals.
Selected Accomplishments:
 Provided ongoing education, support, and access to quality care for patients and caregivers through
regional blood cancer conferences, community programs and the facilitation of peer-to-peer calls.
 Partnered with chapter campaign and donor development staff in revenue-generating activities.
PALMETTO GBA, Columbia, SC, 9/2008 – 6/2013
Outsourced Medicare contract administrator for BlueCross BlueShield of South Carolina
Coverage Policy Specialist
Hired as a member of a team developing training materials for the Centers for Medicare & Medicaid
Services (CMS) on a 5-year contract. Developed and updated comprehensive web-based training
programs posted on the CMS site for a national Medicare provider audience, coordinating with CMS,
internal subject matter experts (SME) and Train-the-Trainer staff.
Selected Accomplishments:
 Interpreted, researched and analyzed CMS regulations and legislation in order to determine
appropriate Medicare policy on selected topics.
 Analyzed CMS Change Request tasks to determine the need for new materials to educate Medicare
providers across the nation, ensuring that national training materials were updated appropriately and
in compliance with CMS regulations and Section 508 compliance.
 Served as a Medicare SME responding to inquiries on Medicare’s national policies.
SOUTH CAROLINA MEDICAL ASSOCIATION (SCMA), Columbia, SC
A 6,000-member physician professional services organization
Director of Practice Management Services, Inc. (PMSI) and Medical Economics, 9/2007 – 8/2008
Managed the enrollment of physicians into the Medicaid medical home network, South Carolina
Solutions, as part of a contract with Community Health Solutions. Marketed the network, recruited
physicians, and presented the benefits and features of participation while concurrently performing all
Manager of Medical Economics job duties.
Selected Accomplishments:
 Provided education on a variety of practice management topics, including Medicaid regulations.
 Successfully met all contractual agreements with Community Health Solutions.

2. KELLY L. DANIAS - 2
437 CADDIS CREEK ROAD | IRMO, SC 29063 | KELLYDANIAS@YAHOO.COM | 803-429-8591
Manager of Medical Economics, 3/1998 – 8/2007
Served as a liaison and advocate between private insurance companies, government programs such as
Medicaid and Medicare, and SCMA members to provide independent, confidential and prompt assistance
on topics such as coding expertise, coverage clarification, bundling explanations, non-payment of claims
and delayed reimbursement. Tracked and recorded all actions performed on behalf of physicians
regarding concerns with insurance companies and resolutions. Planned meetings, coordinated state with
physician delegates on special projects and provided on-site staff support at the meetings. Worked closely
with the delegation chairman on time-sensitive campaign strategy and administrative projects.
Selected Accomplishments:
 Attended the American Medical Association (AMA) House of Delegates and reference committee
meetings, which included relevant reports and resolutions brought before the Council on Medical
Service dealing with fraud and abuse, Medicaid entitlement, HMOs, insurance coverage and coding.
 Delivered presentations and wrote articles for various physician and office manager groups on
Medicaid managed care, the proposed Medicaid waiver, and legislative updates including the impact
of the Medicaid budget on physician reimbursement.
 Ensured distribution of pertinent information through SCMA publications, the monthly Journal of the
South Carolina Medical Association and weekly SCMA Alert newsletter, regarding insurance
program/policy changes, claim issues and government insurance coverage.
 Maintained current knowledge of industry trends and regulatory changes. Attended and reported on
numerous statewide meetings, including: Medicaid Medical Care Advisory Committee (voting
member), Medicare Carrier Advisory Committee, SC Workers’ Compensation Commission Full
Commission, SC Governor’s Maternal; Infant and Child Health Committee, and Department of
Health and Environmental Control’s (DHEC) Maternal, Infant and Child Health Committee.
PALMETTO GBA/BLUECROSS BLUESHIELD OF SC, Columbia, SC, 12/1994 – 3/1998
Medicare Provider Education Specialist
Provided in-office education to physicians and staff across South Carolina regarding billing and coverage
guidelines under Medicare Part B. Additionally responded to phone and written inquiries.
Selected Achievements:
 Created and presented educational workshops for 15-200 participants on Medicare regulations and
program changes receiving highly favorable feedback from physicians and medical management.
Additional Relevant Experience
Store Manager, Ormond Shops, Columbia, SC—Managed every aspect of a women’s clothing store with
a $1 million in annual revenue, including scheduling and training for a staff of 15, inventory control, store
layout, hiring/firing and meeting weekly sales goals.
EDUCATION & PROFESSIONAL DEVELOPMENT
Bachelor of Arts in Public Relations, University of Pittsburgh at Bradford, Bradford, PA
Dean’s List student graduating Cum Laude
Darla Moore School of Business, Executive Education: BCBS Train the Trainer
American Red Cross Cardiopulmonary Resuscitation (CPR)/Automated External Defibrillator (AED)
Trained in Medical Terminology
COMMUNITY SERVICE & PERSONAL INTERESTS
Habitat for Humanity Volunteer
Triathlete; completed in an Ironman triathlon in August 2010