1. Ellen Banning
1814 S. Etting St.
Philadelphia, PA 19145
Ellenbanning1@yahoo.com
267-257-7976
My goal isto become associatedwithacompanywhere Ican utilize myskillsandgainfurther
experience,whileenhancingthe company’sproductivityandreputation.
Areas of Expertise
 CustomerAdvocate
 ComplaintHandling&Resolution
 FollowupwithResolution
 ResearchandRoot Cause Analysis
 Resourceful andProActive
 Excellentcommunicationskills,organizationskills,andattentiontodetail
Professional Experience
Aramark – Suite Catering Administrator 02/2016 to the present
Major Responsibilities:
• Maintains a Guest focus while performing duties
• Assist guests in placing their advance order and plan their event day experience
• Administrate catering orders for all suite owners and rentals at US Bank Stadium
• Communicate the event day needs to the production and service staff
• Communicate any special requests or needs to the culinary team in order to satisfy the guest
and create a memorable experience
• Aid in implementation and adherence to all Aramark catering initiatives and guidelines.
• Maintain a professional image
• Complete special projects as needed

2. Independence Blue Cross —Philadelphia, PA
Medicare Appeals Specialist 10/2013 to 1/2015
Major Responsibilities:
 Responsible forreviewing,analyzingandprocessingpoliciesrelatedtoclaimseventsto
determine the extentof the company'sliabilityandentitlement.
 Conductsinvestigationandreview of customergrievancesandappealsinvolvingprovisionof
service andbenefitcoverageissues.
 Contactscustomersto gatherinformationandcommunicate dispositionof case;documents
interactions.
 Generateswrittencorrespondence tocustomerssuchasmembers,providersandregulatory
agencies.
 Researchesadministrative ornon-clinical aspectsof the appeal,e.g.eligibility,benefitlevels,
overall adherence topoliciesandpractices.
 May make decisiononadministrative appealswhereguidelinesare well documentedand
involve limiteddiscretion.
 Preparesfilesforinternalorexternal reviewbyanalysts,medical staff oroutside consultant.
 Triagesclinical andnon-clinical inquiries,grievancesandappeals,preparescase filesformember
grievance committees/hearings.
 Summarizesandpresentsessential informationfor the clinical specialistormedical directorand
or legal counsel.
Primary Account Contact 5/2003 to 10/2013
Major Responsibilities:
• Researchissues:create/maintainlogsandspreadsheetstotrackissues.
• AssistotherTeamMembersbyanswering questionsandservicingcallsinahighcall volume call
center.
• Collaborate withMarketingaswell asvariouslevelsof Managementtoaddressmember/group
issues.
• Establish contactswithproviders,collectionagencies,andotherBCBSPlanstoprovide
resolutiontocustomerissues.

3. Customer Service Rep 9/2002 to 5/2003
Major Responsibilities:
InboundandOutboundrequestsforthe following:
• Claimsinquiries
• Billinginquiries
• Issue resolution
• Triage to CustomerService,ProcessServicesandSupportingFunctions
• Eligibilityandbenefits
• Takingpayments
• Pre-Authorizationrequirements
• Triage
PC and Technical Skills:
• Detailedknowledge of the AmeriHealth,HMO,PPO,CMM andTraditional line of business.
• Detailedunderstandingof functionsrequiredinclaimsandmemberservicepositions.
• Knowledgeof claimsprocessinginthe applicableadjudicationsystems.
• Advancedknowledge of Blue CardprocessingandITSguidelines.
• Advancedknowledge of the SLIQ/MHSSystem, Planmate,ITS,Oscar/Mainframe,Blue Square,
and CIS.
• Advancedknowledge of Medicare supplemental benefitsandcompliance issues.
• Excel.
• Microsoftword.
Education
Saint Maria Goretti,HS — Philadelphia,PA 9/1977-6/1981
HighSchool Diploma Major: business