Detail-oriented professional with 15 years of experience and demonstrated leadership skills bringing in-depth expertise with root cause and trend analysis to identify issues and develop continuous improvements that lead to cost savings. Defines and documents business processes and requirements for operational reporting. Working knowledge of business intelligence products and high level of computer literacy with spreadsheets, word processing and database software and business systems
Skills
Feature and functionality understanding
Enhancement support
Software and hardware implementation
Data consolidation
Business rule consolidation
Report writing
Solution development
Requirements definition
Project documentation
Best practices and standards
Information security
Team building
Process improvement
Planning and coordination
Problem resolution
Operational improvement
Business operations
Communications
Relationship development
Experience
Business Systems Analyst, 01/2019 - Current Guardian Life – Regional Group Sales, KS,
Documented personnel feedback and developed solutions to address concerns.
Organized and enhanced business rules governing enhancements to existing systems.
Determined areas in need of enhancements and identified relevant and feasible systems to address concerns.
Diagramed and charted problems to facilitate comprehensive analysis.
Contributed to successful field deployment of business systems improvements.
Collected data in field, evaluated findings and produced reports and presentations.
Troubleshot and resolved problems with programs and systems.
Developed and updated SOPs for key functions and features of each system.
Gathered, outlined and reviewed business requirements.
Prepared and delivered targeted systems training for business personnel.
Trained end-users in best practices to minimize errors and protect key data.
Observed staff to study daily tasks regarding information processing and performance to better understand business system needs.
Crafted diagrams and flowcharts outlining logical operational steps.
Claims Manager, 05/2015 - 01/2019 Dart Container Of Michigan – Lincolnshire, IL,
Oversaw onboarding processes for new team members, delivering training on claims handling.
Automated adjudication of clean claims to reduce denial rates, following payer reimbursement policies and procedures.
Managed team members effectively to meet high production standards with accurate results.
Documented personnel feedback and developed solutions to address concerns.
Trained new team members on policies and procedures for claims handling.
Monitored objectives to determine effectiveness of workflows, facilitating training and mentoring for improvement.
Collaborated with quality team regarding quality assurance reviews.
Motivated team members to maintain targeted turnaround time to obtain processing goals.
Delivered exceptional customer service to all clients by effectively communicating information and actively listening to concerns.
Worked closely with team members to deliver project requirements, develop solutions and meet deadlines.
Created agendas and communication materials for team meetings.
Recognized by management for providing exceptional customer service.
Improved customer satisfaction by finding creative solutions to problems.
Improved operations by working with team members and customers to find workable solutions.
Developed consistent procedures and process improvement initiatives, resulting in consistently exceeding Service Level Agreements and Performance Guarantees.
Medical Claims Supervisor, 08/2009 - 05/2015 Dupage Medical Group – Tinley Park, IL,
Created master spreadsheet to record procedures, denials and approvals.
Served as subject matter expert for non-standard coverage questions.
Analyzed insurance organizational structures, business and intermediaries; studied basic documents, including common clauses, policies and insurance contracts.
Fostered relationships with customers to expand customer base and enhance loyalty and retention.
Stayed current on industry trends and changes and participated in professional development opportunities to strengthen product and service knowledge.
Improved operations by working with team members and customers to find workable solutions.
Improved customer satisfaction by finding creative solutions to problems.
Earned reputation for good attendance and hard work.
Created agendas and communication materials for team meetings.
Worked closely with team members to deliver project requirements, develop solutions and meet deadlines.
Provided excellent service and attention to customers when face-to-face or through phone conversations.
Education and Training
: International Business, Expected in - Seton Hill College - Greensburg, PA, GPA:
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