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Skills

  • New employee onboarding
  • Cross-functional team collaboration
  • Account management
  • Compliance with insurance regulations
  • Process improvement
  • Documentation abilities
  • Data analysis using SAP
  • Certified in Lean
  • Confidentiality management
  • MS Office

Work Experiences

  • Assisted in the implementation of a new CRM system.
  • Reviewed open requests and redirected workloads to ensure that projects were completed on time.
  • Achieved a 32% decrease in intake processing errors.
  • Adjusted staff workloads for timely intake.
  • Achieved a favorable resolution in 27% of cases.
  • Assisted in the design of standardized intake forms.
  • Achieved a 52% retrieval success rate.
  • Confirmed policyholder coverage details.
  • Communicated clearly with diverse teams to resolve cross-functional issues, directly contributing to a 71% improvement in team workflow.
  • Aligned intake processes more closely with regulatory changes, improving compliance scores by 59%.

Summaries

  • Achieved 29% accuracy.
  • Client-focused Claims Intake Specialist with a history of improving satisfaction scores by 68% through proactive communication and accurate claims status updates.
  • 8 years of experience.
  • Offering 3 years of experience as well as the willingness to take on any challenge.
  • Adept at conflict de-escalation.
  • Achieved results over 14 months.
  • Achieved 75% first-call resolution rate.
  • Within Mental Health, senior Claims Intake Specialist and outstanding performer in process improvement and risk assessment.
  • Listening to customers, meeting productivity goals, and staying current on company offerings are all skills she possesses.
  • Adept at CRM system implementation.

Accomplishments

  • Mentored junior specialists on claim intake processes, increasing individual team member productivity by 31%.
  • Contributed to the reduction of claim turnaround times by 6 days through consistent collaboration with third-party vendors.
  • Improved communication channels between intake specialists and claims adjusters resulting in error reductions of 68%.
  • Interfaced with healthcare providers to validate patient information, lowering rejection rates on healthcare claims by 15%.
  • Maintained detailed documentation of all intakes, ensuring compliance with HIPAA and confidentiality regulations.
  • Initiated a regular review of intake bottlenecks, addressing inefficiencies and improving processing speed by 15%.
  • Collaborated with team of 10 in the development of metric.
  • Participated in cross-functional team meetings designed to rework claim intake priorities, leading to more efficient handling of sensitive cases.
  • Coordinated with claims department to identify discrepancies, leading to a 55% reduction in delayed claims.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.

Affiliations

  • Accredited Claims Adjuster (ACA) Certification Association
  • National Healthcareer Association (NHA)
  • Association of Information Technology Professionals
  • National Underwriter Association for Claims Processing Standards
  • Certified Claims Professional Accreditation Council (CCPAC)
  • International Council of Nurses
  • American Health Information Management Association (AHIMA)
  • National Association of Professional Adjusters (NAPA)
  • National Association of Claims Professionals (NACP)
  • International Association of Administrative Professionals

Certifications

  • Insurance Billing and Coding Specialist Certification (CBCS) - National Healthcareer Association
  • General Insurance (INS) Certification - The Institutes
  • Licensed Adjuster Certification - Ohio
  • Certified Public Accountant
  • Project Management Professional (PMP)
  • Certified Managed Care Professional (CMCP) - procedure
  • Certified Healthcare Claims Professional (CHP) - Meridian
  • Certified Casualty Claims Specialist (CCC) - Harbor & Co.
  • Accredited Claims Adjuster License - process
  • Health Care Compliance Certification (HCCP) - Compliance Certification Board

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