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Work Background
CignaClaims Processor Senior Associate
Aug. 2001 - Sep. 2013Work at HomeIdentified necessary steps and processed/adjusted claims and correspondence of varying complexity levels. Researched, analyzed, and priced claims in accordance with processing guidelines as well as provider and customer contracts. Worked with Claims Manager to develop policies, procedures and the business work plan for the team and recommended operational improvements when appropriate. Paid/denied claims and worked correspondence across all claim types. Determined whether to uphold or overturn provider disputes. Provided recommendations regarding process improvements. Performed activities such as leading team in initiatives or special projects. Worked independently and took initiative in completing work assignments and other project work. Demonstrated customer centric attributes and associated behaviors to deliver exceptional customer experiences. Coached and supported peers. Provided a superior level of professionalism and knowledge when communicating with internal and external matrix partners/customers. Ensured privacy and confidentiality as required by HIPPA guidelines.
Presence HealthOffice Manager - Occupational Health Clinic
Aug. 1998 - Aug. 2001Bourbonnais, Illinois, United StatesOversaw day-to-day office operations. Managed communications with business contacts and patients. Helped streamline office operations including SOP’s, internal compliance and HIPPPA compliance. Assisted in recruiting and onboarding of office and nursing staff. Provided administrative support, record keeping and maintaining databases. Delegated and assigned tasks as necessary. Held annual performance reviews. Conducted new hire training and onboarding. Maintained office supplies, inventory and carried out purchase orders and supply requests. Scheduled and registered patients. Payroll. Dictation/Transcription.
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