Michael Ransom
Richardson,TX
Summary
Professional Project Management Specialist with experience working with teams to accomplish short- and long-term project goals. Managed budgets and monitored project costs.
Overview
13
13
years of professional experience
Work History
Project Delivery Specialist
HealthCare Service Corporation: Blue Cross Blue Shield of Illinois, Montana, New Mexico, Oklahoma, and Texas
01.2018 - Current
- Support testing and quality assurance assessments to evaluating and ensuring system functionality aligns with expected results.
- Reviewed test cases for accuracy and expectations for results.
- Support IT projects and system fixes by completing duties ranging from research and claims investigation, testing, and release support.
- Create Epics and User Stories in Agile development.
- Track, report, and resolved testing and production defects.
- Enhanced project delivery efficiency by streamlining communication and collaboration among team members.
- Maintained comprehensive documentation throughout the lifecycle of each project, ensuring easy access to information when needed.
- Facilitated stakeholder engagement through regular status updates and progress reports, fostering transparency and trust.
- Continuously worked toward process improvements by reviewing best practices in project management methodologies such as Agile or Waterfall approaches.
Claim Recovery Coordinator
HealthCare Service Corporation: Blue Cross Blue Shield of Illinois, Montana, New Mexico, Oklahoma, and Texas
01.2015 - 01.2018
- Provided post adjudication review of paid claims for potential overpayments, resulting in recoveries between $350 and $400 million annually
- Primary trainer for internal hires entering the Claim Recovery Unit and existing employees learning new projects
- Vetted and tested new projects before rolling out to the department
- Wrote and updated training materials including project guidelines for departmental use
- Conducted observations for quality and production for staff
- Traveled to remote sites to conduct training
- Provided second-level support to Claim Recovery Technicians on issues of high complexity
- Reviewed quality findings for accuracy and rebuttal
- Trained and advised third-party vendors on department flows and processes.
- Collaborated with various groups to troubleshoot and resolve build and deployment issues.
- Developed, implemented and operated network system infrastructure and procedures.
- Identified potential barriers to successful recovery early on and proactively addressed them through targeted interventions.
Senior Claims Technician
HealthCare Service Corporation: Blue Cross Blue Shield of Illinois, Montana, New Mexico, Oklahoma, and Texas
01.2014 - 01.2015
- Worked with claims issues of high complexity and provided first level support to 10-15 workers.
- Supported the developmental team in on-boarding and mentoring new hires beyond initial training.
- Collaborated with team members to improve communication, resulting in a more productive work environment.
- Balanced competing priorities effectively while managing a diverse caseload, ensuring timely and accurate claim resolution for clients.
Claims Examiner
HealthCare Service Corporation: Blue Cross Blue Shield of Illinois, Montana, New Mexico, Oklahoma, and Texas
01.2012 - 01.2014
- Resolved claims issues of minor and intermediate complexity in a production environment.
- Determined coverage and benefit eligibility
- Claims primarily for members of Blue Cross Blue Shield of Illinois out of the Springfield Office
- Worked on the Inter-Plan claims team, communicating with other Blue Cross plans.
- Served as a learning coach to train and mentor new hires.
- Researched claims and incident information to deliver solutions and resolve problems.
Education
Bachelor of Arts in History -
University of Iowa
Iowa City, IA12.2009
Skills
- Requirements Gathering
- Business Analysis
- Scrum Framework
- Project Scheduling
- Stakeholder Management
- Technical understanding
- Stakeholder Relations
- Requirements Writing
Military Service
US Army, 07/01/1999, 09/01/2005, Specialist/ E-4, 11B Infantryman and 15T Utility Helicopter Repairer, US Army Air Ambulance Detachment, Fort Polk, LA, I served for six years on active duty and held several positions within two job fields, Infantry and Aviation. As an Infantry team leader, I was responsible for the conduct of four soldiers and their training. Following a change of specialty, I served as a Crew Chief for medical evacuation helicopters. My primary responsibilities for this included performing and supervising maintenance as well as being part of an aircrew. During my six years on active duty, I was afforded the opportunity to serve in several states from Alaska to Louisiana. While on active service, I was awarded two Army Commendation medals and the Army achievement medal and was selected as battalion soldier of the year in 2002.
Timeline
Project Delivery Specialist
HealthCare Service Corporation: Blue Cross Blue Shield of Illinois, Montana, New Mexico, Oklahoma, and Texas
01.2018 - Current
Claim Recovery Coordinator
HealthCare Service Corporation: Blue Cross Blue Shield of Illinois, Montana, New Mexico, Oklahoma, and Texas
01.2015 - 01.2018
Senior Claims Technician
HealthCare Service Corporation: Blue Cross Blue Shield of Illinois, Montana, New Mexico, Oklahoma, and Texas
01.2014 - 01.2015
Claims Examiner
HealthCare Service Corporation: Blue Cross Blue Shield of Illinois, Montana, New Mexico, Oklahoma, and Texas
01.2012 - 01.2014
Bachelor of Arts in History -
University of Iowa
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