1. Patricia Singh
33421 SW 88th
Pl Unit 101
Cutler Bay Fl 32256
Home Phone-281-6396
Email: jacpats@yahoo.com
June 8, 2015
Career Objective: To enhance and share my knowledge while establishing a career with achieving
goals on educating and motivating.
Dec 1997-Dec 2014
Employment
Florida Blue
Specialist 11B Provider Connectivity Solutions
Duties include resolution of multiple transactions such as authorizations / referrals, claims data and
Electronic Remittances. Additionally, provide feedback in the form of continuous education to
providers and business partners on all Self Help Tools. Review all project material and provide
Subject Matter Expertise proactively as changes in the health industry occur with a proactive
resolution. Empower customers to utilize the Self Help Tools and build relationships with all
internal and external customers. Identify Root Cause and work issues with Information Technology
Florida Blue
Provider Solutions Advisor- Network Management Aug 2011- 2012
To engage the provider community on using all Self Help Tools that Florida Blue offers. Resolving
issues that the Service Organization that requires escalation such as balance billing and claim
denials and clarifying contract with providers/members who has difficulty understanding their
contractual/ benefit obligations. Work projects on targeted providers and vendors from a quality
perspective. Research problems/ issue and work cohesively with internal / external customers to
resolve in accordance with guidelines set forth. Resolved both members and providers disputes
and worked towards a positive outcome for the customer.
Track and trend issues and proactively engage all business partners to provide t input for positive
resolution.
Identify root cause and provide feedback to all internal and external customers.
Florida Blue
Senior Advisor / Interim Manager– Provider Contact Center Jan 2006 to Aug
2011
Job responsibilities include responding to all escalated inquiries creating, Desktop Procedures, First
Contact Resolution, also interacting with all areas internally to resolve any issue. I was engaged
with Training and ACS Vendors to ensure that all guidelines are met in resolution of calls to the

2. Provider Contact Center. Had iterim roles as Supervisor for Provider Contact Center.
Additionally, responsibility to create and Desktop Procedures and ensure that all technical issues
are understood by front line associates.
With experience of Senior Advisor in the interim role as a Supervisor for the Provider Contact
Center , I coordinated work schedules with Work Force Management, and concentrated on First
Contact Resolution ensuring that the customer was educated/satisfied and offered various ways
of resolving critical issues. Continued networking with other internal cusomers to gain successful
results both for members and providers. In role as a Supervisor ensure that team moral ws not
affected by any company changes in direction and built strong relations hips with internal and
external customers in regards to first contact resolution
Florida Blue Miami, Florida
Provider Liaison Support Representative September 1999
to 2006
Process and adjust claims for all lines of business, in accordance with member’s benefits and
providers’ contract, Also Educate providers on electronic submission and advice of correct billing
standards and practices. Interact with Provider Contact Center on continuous improvement from a
Quality perspective and support Contractors on conflicting issues. Work with process improvement
teams on capturing issues and resolutions in a timely manner. Respond to all written inquiries
including member and provider impacted working towards building relationships , which in result
created loyalty and customer focus results. Performed in the Role of Outband Contact for Tenet
Health Systems for all ines on business, and was involved in multiple projects for providers, on
claim payment issues.
Florida Blue Miami, Florida
Senior Claims Examiner October 1997 to
Sept. 1999
Provide timely processing of claims under strict contractual obligations. Responsible
for processing multiple providers based on specific contract procedures and guidelines. Review
member benefits, limitations, exclusions and eligibility to identify potential COB, TPL, auto and
worker compensation issues. Priced claims using specific benefit packages on MHS as well as
using the Claim Check System. Other responsibilities of the position include making provider
network determination, resolving provider loading issues as well as reviewing provider activity for
detecting fraud.
Miami Children’s Hospital Miami, Florida
Imaging Team Leader Sept. 1991 to October
1996
Prepared medical documents for scanning, which involved very important scrutiny of document.
Scanned and indexed documents to the medical record. Served as a liaison for s staff to supervisor
relations. Assembled discharges on patients in a timely fashion and assisted physicians in
completing their Incomplete Records for Joint Accreditation Commission. Filed loose documents in
patient medical records.

3. South Motors Miami, Florida
Cashier/Receptionist April 1990 to April 1991
Greeted customers and assisted them in dealership questions. Received payments for work
performed on vehicles. Prepared Account Payable and Receivable reports.
Singh, Patricia Page 3
MDS Laboratories Toronto, Ontario, Canada
Home Care Coordinator September 1980 to April
1990
Coordinated home visits for laboratory personnel and Home care patients and called in results to
physician offices. Data Entry orders from physicians and in general interacted with different
governmental agencies for care or the elderly. Worked closely with case management for home
care for the elderly.
Education
National School of Technology Miami, Florida
Humber Community College Ontario, Canada
General Studies
* Detailed information in regards to education dates of attendance available upon request.
Systems/PC Software Skills Claims & Services Training
FEP CPT &ICD-9 Coding
NASCO Direct HMO
Diamond System Blue Care Simplified
Products
MHS (Managed Health System) Preferred Patient Care
IMS (Integrated Managed System Care Manager
ICN (Inquiry Control Numbers System) Point of Service products
Microsoft Office 1997 (Word, Excel, Access, Power Point) Siebel
NICE
Blue Card AVAILITY
Microsoft Office 2000 (Currently training on the new software product)
References Furnished Upon Request