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Work experience

Nov 2009Present

Pharmacy Claims Analyst

WELLCARE INSURANCE

• Tripled the Company’s Net Income to $2M of state contracts.

• Increased Gross Revenues from $4 to $6M of project management.

• Negotiated increased Reimbursement Rates from vendors by 10%.• Reduced Medicare/Medicaid – HMO/PPO/PFFS annual liability insurance premiums $800K.

• Prepare over 25 orders daily; verified prescription dosage and quantity to be dispensed.

Track 100+ daily activity logs of departmental activities.

Nov 2007Nov 2009

Account Management

HUMANA INSURANCE COMPANY, Tampa, FL

(Claims, Billing, Pharmacy, Enrollment, Benefits & Eligibility)

·Managed applications networking orders for over 13,000 nationwide customers.

·Assessed over 500 high volume vendor accounts.

·Computed & resolved billing & enrollment at 100% accuracy.

·Improved over 50+ Medicare/Medicaid individual/group health insurance by customizing.

·Marketed with 20 companies across industries; council 25 benefit packages for our clients.

·Prioritized up 20 daily follow-ups to ensure timely resolution.

·Evaluated an average of 25 problems to the customer’s satisfaction.

·Emphasized to members and providers on the values of over 85 products and services by up sales.

Apr 2004Oct 2007

Accounting Analyst

COCA-COLA ENTERPRISES, INC

·Saved $4M+ through negotiations with vendors about variances in write-offs.

·Audited 200 invoices monthly; generated/sent 50 reports monthly for financial reconciliation.

·Supervised the disbursement of $100M+ over 5 years for Canadian office support.

·Managed a major project which balanced 80 neglected and critical, large accounts.

·Eliminated double payments of invoices; created a tracking database for report correlation.

Education

Master of Science, Business Administration

Nova Southeastern University

Skills

AS/400
Microsoft Dynamics Great Plain, Project, Visio
Microsoft Office Suite
SQL Design and relational database
FICO (SAP/R3 Pinnacle & Legacy)

References

Terry Richardson

Sophia is a very hard-working, conscientious person with a true heart for her clients. She is truly an asset to all. Sophia is a very smart and hard worker. She will work what ever hours needed to successfully complete the job. She volunteers useful comments without being prodded and, when called upon unexpectedly to answer a question, she can always frame an intelligent response. Terry Richardson, Account Executive Representative, worked with Sophia at Coca-Cola Enterprises

Joseph Terry

"Sophia is an energetic, passionate, and driven employee who strives to move the business ahead. It was my pleasure to supervise Sophia’s efforts in her role as a project leader for finance support (GRIR team) - I always felt I could rely on Sophia’s energy to get the job done. When promoted to our area, she brought vast amount of organizational skills which helped her tremendously with her methodical research protocols. Having strived for superior customer service, she was recommended for employee recognition by her one of her accounts. If I had an appropriate opportunity, I would welcome an opportunity to work with him again and would hire her without batting an eyelid."

Jason Brooks

"Any organization fortunate enough to have Sophia working for them deserves to be congratulated. Any other organization should be envious. In the time I have known Sophia, she has proven to me to be a resourceful and creative individual with a keen eye for innovation. Energy, confidence, and determination are her key attributes, and she is sure to be an integral contributor within any company.”

Heidi Tracy

"I have known Sophia personally and professionally for over 2 years. She is a loyal friend and consummate professional whom I would recommend unhesitatingly to anyone. Over recent years, Sophia has received well deserved recognition within the beverage industry for her knowledge of vendor maintenance & accountability. She is a pleasure to do business with."

Ron Pierre

“I used to support Sophia, Account Analyst, and I was certain that she had control of all the aspects she managed including the financials, her targets and also relationship within and outside the company. It was a very rich experience to work with such an experience professional. Sophia always displays true integrity and is well respected by his peers. She is an ardent advocate for her vendors and would be a valued addition to any company."

Summary

A dynamic and well educated (MBA); Healthcare Management Analystwith three (3) years in pharmacy claims; three (3) years as a Financial Analyst;

Following are hard hitting, bottom lineaccomplishments:

  • Tripled the Company’s Net Income to $2M for state contracts
  • Increased Gross Revenues from $4 to $6M for project management
  • Negotiated increased Reimbursement Rates from vendors by 10%
  • Reduced annual liability insurance premiums $800K
  • Managed systems and applications networking orders support for over 13,000 U.S. customers representing a business value of $750 million
  • A hands-on, self motivated, results oriented, leader
  • Management/business development skills; increased Net Income a minimum of 15%

Interest

Personal level:

Sight seeing

Long walk on the beach

Walking

Dancing

Professional level:

  • Career opportunities
  • New ventures
  • Job inquiries
  • Expertise requests
  • Rference requests
  • Certifications

    Certification in Pharmacy

    Sanford-Brown Institution