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Eligibility Analyst Senior Associate Resume Example

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ELIGIBILITY ANALYST SENIOR ASSOCIATE
Professional Summary
Proven customer service skills developed over a 10 year period working for various organizations such as Cigna, Denver Health Medical Center, HCA/HealthONE Excellent interpersonal, verbal and written communication skills 10 years of research experience with an exceptional ability to focus on minor details Excellent computer skills with over 10 years experience working with Microsoft Office programs such as MS Word, MS Excel, MS Outlook and multiple databases including Facets Expert data entry skills, able to type 60 words per minute and perform 10 key by touch Top notch analytical and organizational skills, extremely detailed oriented with the ability to multi-task and complete required tasks and meet strict deadlines in a fast paced work environment Independent worker with an exceptional ability to prioritize tasks and coordinate with team members
Core Qualifications
  • Client-focused
  • Quick learner
  • People-oriented
  • Excellent communication skills
  • Goal-oriented
  • Excellent time management skills
Experience
Eligibility Analyst Senior Associate
September 2015 to CurrentCompany Name － City, State
  • Responsible for managing the electronic eligibility files or manual eligibility data in the core system for at least 50 assigned cases, including the implementation, renewal, and maintenance activities for Cigna Clients.
  • Identify any file formatting or data integrity errors, and partnering with internal and external partners to create a positive client experience.
Account Installation Sr. Associate/Billing Install Analyst
September 2013 to September 2015Company Name － City, State
  • Managed a Book of Business and processed group medical rates on the Facets platform, across all plans and subgroups for new business, renewals, amendments and terminations.
  • Installed new cases in Facets accurately and timely each month by following the Facets New Group Workflow.
  • Adhered to policies and procedures and attention to detail and accuracy necessary for both the customer and internal customers.
  • Knowledge of proper Facets setup essential for ensuring billing can be released and customers receive accurate billing statements each month.
Document Assistant/Return Mail Processor
August 2011 to September 2013Company Name － City, State
  • Processed incoming and outgoing mail adhering to Document Control policies and procedures.
  • Managed mail processing, sorting and distribution.
  • Managed workflow during peak and low seasons with the goal of leveling work load year round.
Account Installation Associate/Premium Rate Specialist
December 2008 to April 2011Company Name － City, State
  • Top performer recognized for 100% accuracy rating for 2010 ensuring customers had correct billing statements Managed caseload of 70 or more customers and ensured all data was properly entered within designated time frames Performed detailed self-audits on existing customers or new customers daily to maintain high level of customer satisfaction Coordinated with multiple internal customers to ensure timely completion of all cases Resolved complex problems by researching technical issues and inputting required corrections in Facets.
Security Coordinator
January 2008 to December 2008Company Name － City, State
  • Set up new user accounts for new employees and made changes for tenured employees to ensure access and provide staff with tools necessary to complete daily operations.
  • Provided access to CHI applications, network and data environments per security policies and operational standards.
  • Coordinated with internal customers to reset passwords, provide access to computer applications, and set up multiple users in support of company operations.
  • Researched account issues to determine origin of access problems and resolve them in a timely manner.
Batch Analyst
October 2006 to September 2007Company Name － City, State
  • Managed batch report for 6 different facilities to ensure accurate processing of daily payment transactions.
  • Corrected errors on daily report to ensure each transaction was processed in a timely manner.
  • Communicated effectively with internal patient accounting staff via email to obtain accurate data to make payment/charge corrections.
Billing Specialist
September 2005 to April 2006Company Name － City, State
  • Ran daily discoverer reports and determined which Service Requests were completed and ready to be invoiced Determined the correct A/R account for billing purposes and verified all information was accurate Verified warranty status and correct amount to charge the customer Identified and reported billing mistakes to prevent unnecessary write offs Billed approximately 2000 invoices a month worth approximately $200,000.
Lead Clinic Clerk
May 2003 to September 2005Company Name － City, State
  • Managed $3,000-$5,000 worth of payments for Behavioral Health Services rendered Prepared money for daily cash deposits and coordinated with campus security for pick up Coordinated with upper management and researched account discrepancies to ensure accurate reconciliation of patient accounts Trained employees to ensure that proper cash handling procedures were followed Provided customer service and managed physicians/counselors daily schedules by scheduling appointments via phone or in person and preparing paperwork Entered billing codes to ensure payment for services and treatments rendered.
Youth Employment Specialist/Coordinator
May 2002 to August 2002Company Name － City, State
  • Provided daily employment counseling and job placement services for 15 teenagers per week to assist employers with filling vacancies while providing summer jobs for youths.
  • Coordinated daily with up to 15 different employers per week to match employer needs with youth interest to ensure successful placements.
  • Managed database of 100+ positions available to youth in the citywide teen employment program.
Program Coordinator
April 2001 to February 2002Company Name － City, State
  • Scheduled orientations for Quickstart Careers, which assisted dislocated workers in furthering their education to obtain stable employment Determined applicant eligibility by adhering to program guidelines to ensure applicant met criteria to receive government funds Reviewed applications for accuracy to ensure all necessary documentation was provided in order to give proper funding to each applicant Assisted in quality job placement for all eligible applicants Established personal contact with perspective employers Maintained contact with employers and conducted onsite visits Tracked and reported attendance and compliance of participants.
Education
B.S : Business Management, May 2000Grambling State University － City, StateBusiness Management
Skills
accounting, scheduling appointments, attention to detail, Behavioral Health, billing, daily cash deposits, cash handling, computer applications, counseling, customer satisfaction, customer service, database, documentation, email, filling, funds, policies, quality, researching, sorting, phone, workflow
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Resume Overview

School Attended

  • Grambling State University

Job Titles Held:

  • Eligibility Analyst Senior Associate
  • Account Installation Sr. Associate/Billing Install Analyst
  • Document Assistant/Return Mail Processor
  • Account Installation Associate/Premium Rate Specialist
  • Security Coordinator
  • Batch Analyst
  • Billing Specialist
  • Lead Clinic Clerk
  • Youth Employment Specialist/Coordinator
  • Program Coordinator

Degrees

  • B.S : Business Management , May 2000

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