Benny Mallory
Summary
Dynamic professional seeking a position within a reputable organization that values long-term commitment and fosters growth opportunities. Committed to contributing to the company's success while enhancing its image through dedicated service and innovative ideas. Strong focus on achieving results and driving positive change aligns with the goal of establishing a rewarding career. Passionate about being part of a team that prioritizes excellence and sustainability in its operations.
Experienced with navigating complexities of health insurance policies and regulations. Utilizes in-depth knowledge to provide clear, actionable advice to clients. Track record of maintaining client satisfaction through effective communication and personalized support.
Overview
29
29
years of professional experience
Work History
Director of Respiratory Therapy
Divinity Repiratory services
- Manage departmental accounts, track and reconcile department budgets. Manage and coordinate the delivery of medical services, assess and evaluate the physical and psychological factors of adults, neonatal, pediatric, and geriatric patients. Manage a small staff of respiratory therapists. Manage supply and pharmaceutical inventory, Manage employee schedules, floor management, new hire training, hiring of respiratory therapists and other key positions in the department.
- Barton AM White, Jacksonville FL – Manage departmental accounts, track and reconcile department budgets. Manage and coordinate the delivery of medical services, assess and evaluate the physical and psychological factors of adults, neonatal, pediatric, and geriatric patients. Manage a small staff of respiratory therapists. Manage supply and pharmaceutical inventory, Manage employee schedules, floor management, new hire training, hiring of respiratory therapists and other key positions in the department.
- Led development and implementation of respiratory care protocols to enhance patient outcomes.
- Managed departmental budget, ensuring efficient resource allocation and cost control measures.
- Collaborated with interdisciplinary teams to integrate respiratory therapy into comprehensive patient care plans.
- Streamlined operational processes, resulting in improved workflow efficiency within the department.
- Conducted regular performance evaluations, providing feedback and guidance to enhance team effectiveness.
Respiratory Therapist
University Hospital (Shand's)
Respiratory Therapist
Charter Memorial Hospital
Respiratory Therapist
Baptist Hospital
Technical Analyst
Humana Healthcare
01.2002 - Current
- The Business Analyst is responsible for the development, implementation and documentation of technical enhancements as they relate to the improvement and resolution of system issues involving the functionality and performance of mainframes, as well as processing and running claim projects on daily, weekly and monthly basis. Processing Analyst directly supports 20 departments in daily processing needs.
- Humana Healthcare, Jacksonville, Florida – The Business Analyst is responsible for the development, implementation and documentation of technical enhancements as they relate to the improvement and resolution of system issues involving the functionality and performance of mainframes, as well as processing and running claim projects on daily, weekly and monthly basis. Processing Analyst directly supports 20 departments in daily processing needs.
Auditor
Humana Healthcare
01.2000 - 01.2002
- The Auditor is responsible for meeting and exceeding all unit standards related to Quality and Production, for HMO, Medicare HMO, PPO, ASO, POS and Medicare Supplemental products, in accordance with claims payment policy and the terms of contractual agreements. Review complex contracts, detect system/benefit errors and complete root cause analysis to prevent future errors. Identify process improvements, verify, and examine all financial accounts/records to ensure that policy and procedural claims guidelines are in adherence. Facilitate and conduct training for associates. Maintain and update multiple required reference materials to adjudicate claims.
- Humana Healthcare, Jacksonville, Florida – The Auditor is responsible for meeting and exceeding all unit standards related to Quality and Production, for HMO, Medicare HMO, PPO, ASO, POS and Medicare Supplemental products, in accordance with claims payment policy and the terms of contractual agreements. Review complex contracts, detect system/benefit errors and complete root cause analysis to prevent future errors. Identify process improvements, verify, and examine all financial accounts/records to ensure that policy and procedural claims guidelines are in adherence. Facilitate and conduct training for associates. Maintain and update multiple required reference materials to adjudicate claims.
Lead Benefits Analyst
Humana Healthcare
01.1999 - 01.2000
- The Lead Benefit Analyst is responsible for supporting Claims Department (30 employees) Facilitate and conduct new hire training and processing updates. Generate and distribute reports, research, resolve and process complex issues using special overrides. Special projects as assigned. Manage workflow for associate claims adjudication, assist supervisor with training, development, floor management and benefit analysts.
- Humana Healthcare, Jacksonville, Florida – The Lead Benefit Analyst is responsible for supporting Claims Department (30 employees) Facilitate and conduct new hire training and processing updates. Generate and distribute reports, research, resolve and process complex issues using special overrides. Special projects as assigned. Manage workflow for associate claims adjudication, assist supervisor with training, development, floor management and benefit analysts.
Customer Service Claims Specialist
Humana Healthcare
01.1999 - 01.1999
- Provide prompt, accurate and professional customer service and in-depth analytical support. Review, resolve, and answer all in-bound calls regarding insurance claims, eligibility, referral status, and benefit inquiries.
- Humana Healthcare, Jacksonville, Florida - Provide prompt, accurate and professional customer service and in-depth analytical support. Review, resolve, and answer all in-bound calls regarding insurance claims, eligibility, referral status, and benefit inquiries.
Claims Analyst
Humana Healthcare
06.1998 - 01.1999
- Adjudicate and process Physician and Hospital healthcare claims for HMO, Medicare HMO, POS, PPO and Medicare Supplemental product lines. Processed high dollar claims. Assisted Technical Specialists with complex processing issues. Assisted in multiple special projects with a focus on training and implementation of new processing procedures. Assisted in the documentation of new processing procedures.
- Humana Healthcare, Jacksonville, Florida - Adjudicate and process Physician and Hospital healthcare claims for HMO, Medicare HMO, POS, PPO and Medicare Supplemental product lines. Processed high dollar claims. Assisted Technical Specialists with complex processing issues. Assisted in multiple special projects with a focus on training and implementation of new processing procedures. Assisted in the documentation of new processing procedures.
Customer Service Claims Specialist
Blue Cross/Blue Shield of Florida
01.1998 - 06.1998
- Review and resolve claim inquiries for adjudication. Answering and resolving all in-bound calls in a courteous and timely manner.
- Blue Cross/Blue Shield of Florida, Jacksonville, Florida - Review and resolve claim inquiries for adjudication. Answering and resolving all in-bound calls in a courteous and timely manner.
Claims Analyst
Prudential Insurance Company of America
03.1997 - 01.1998
- Adjudicate and process Physician and Hospital healthcare claims for HMO, Medicare HMO, and POS, PPO and Medicare Supplemental product lines. Processed high dollar claims. Assisted Technical Specialists with complex processing issues. Assisted in multiple special projects with a focus on training and implementation of new processing procedures. Assisted in the documentation of new processing procedures.
- Prudential Insurance Company of America, Jacksonville, Florida - Adjudicate and process Physician and Hospital healthcare claims for HMO, Medicare HMO, and POS, PPO and Medicare Supplemental product lines. Processed high dollar claims. Assisted Technical Specialists with complex processing issues. Assisted in multiple special projects with a focus on training and implementation of new processing procedures. Assisted in the documentation of new processing procedures.
Education
Associate - Respiratory Therapist
Flagler Career Institute
Jacksonville, Florida08.1994
H.S. - General Education
Englewood Senior High School
Jacksonville, Florida06.1990
Skills
- Clinical expertise
- Patient care coordination
- Staff development
- Performance improvement
- Interdepartmental collaboration
- Teamwork
- Teamwork and collaboration
- Customer service
- Problem-solving
- Time management
- Attention to detail
- Problem-solving abilities
- Multitasking
- Multitasking Abilities
- Reliability
- Critical thinking
- Excellent communication
- Active listening
- Organizational skills
- Adaptability and flexibility
- Decision-making
- Relationship building
- Training and mentoring
PROFESSIONAL PROFILE
Human Resource Development, Quality and Performance Management, Supervisory Skills, Customer Service Operational Management Skills, Medical Office / Case Management Skills, Sales Marketing, Accounting / Business Applications, and Computer literacy skills.
Section name
Proficient in Microsoft Word, Excel, and Lotus Notes. Knowledgeable in Microsoft Access.
Timeline
Technical Analyst
Humana Healthcare
01.2002 - Current
Auditor
Humana Healthcare
01.2000 - 01.2002
Lead Benefits Analyst
Humana Healthcare
01.1999 - 01.2000
Customer Service Claims Specialist
Humana Healthcare
01.1999 - 01.1999
Claims Analyst
Humana Healthcare
06.1998 - 01.1999
Customer Service Claims Specialist
Blue Cross/Blue Shield of Florida
01.1998 - 06.1998
Claims Analyst
Prudential Insurance Company of America
03.1997 - 01.1998
H.S. - General Education
Englewood Senior High School
Director of Respiratory Therapy
Divinity Repiratory services
Respiratory Therapist
University Hospital (Shand's)
Respiratory Therapist
Charter Memorial Hospital
Respiratory Therapist
Baptist Hospital
Associate - Respiratory Therapist
Flagler Career Institute