Aleasha Brooks

Claims Supervisor/SME/TL/Trainer at UST HealthProof
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Contact Information
us****@****om
(386) 825-5501
Location
Plano, Texas, United States, US

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Bio

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Credentials

  • Managing Virtual Teams
    LinkedIn
    Sep, 2021
    - Nov, 2024
  • Motivate Remote Teams
    LinkedIn
    Sep, 2021
    - Nov, 2024

Experience

  • UST HealthProof
    • United States
    • Hospitals and Health Care
    • 100 - 200 Employee
    • Claims Supervisor/SME/TL/Trainer
      • Sep 2021 - Present

      • Processing Medicare Advantage claims using the Advalent claims platform.Adding/Updating Provider contracts and data.Adding/Updating Member data.Remediating tickets for configuration and product teams.Analyzing data and Initiating small projects and completing them. Working closely with the client to understand goals and objectives.Responsible for directly managing a staff of 35-40 associates• Responsible for day to day interaction with client organization to help run a high-quality claims operation• Implement a daily operations governance process to analyze, prioritize and deliver daily, weekly, monthly targets• Collaborate with the client in creating claims reports (inventory, production, productivity, priority and forecasting) to meet and exceed all production Service Level Agreements (SLA)• Collaborate with client and Audit team to understand and establish a robust Quality program – to measure, analyze, root cause analysis and take and take Corrective Actions as needed • Establish a transparent communication plan with client Claims leadership to address issues, concerns and take preventive measures to avoid service quality issues• Ensure setting smart goals for teams and provide regular feedback, appraisal and coaching to ensure performance• Be responsible for managing personnel matters like attendance, holidays, PTO, sick days, approve hours for payroll, shift timings etc. with the prime objective of meeting and exceeding customer deliverables• Being a Subject Matter Expert (SME) to ensure that Standard Operating Procedures (SOPs) are adequate for the needs of the operations teams, review them periodically for updates and enhancements and ensure version control and client approvals and created Desk Level Procedures (DLPs)• Undertake special project(s) as defined a deemed necessary by the UST management teams• Participate in meetings and project activities outside of the primary location at locations determined by UST management team

  • Cognizant
    • United States
    • IT Services and IT Consulting
    • 700 & Above Employee
    • Subject Matter Expert
      • Apr 2021 - Sep 2021

      Coaching/Training Texas Parkland Health plan Medicaid plans using the QNXT claims platform.• CREATING DESK LEVEL PROCEDURES FOR PROCESSING CLAIMS• ASSISTING WITH COMPLEX/UNEXPECTED MATTERS• AUDITING FOR FINANCIAL AND PROCESS ACCURACY – SUBJECT MATTER EXPERT• ASSISTING WITH CONFIGURATION OF CLAIMS• APPEALS & GRIEVANCES CASES/ESCALATIONS• ONBOARDING AND TRAINING NEW HIRES• PROVIDING/UPDATING ACCESS FOR EMPLOYEES• DEVELOPING PROCESSES AND GUIDELINES/TRAINING DOCUMENTS• COACHING FOR QUESTIONS/AUDIT ERRORS• AUDITING PROCESSORS

  • NTT DATA Services
    • United States
    • IT Services and IT Consulting
    • 700 & Above Employee
    • HC & Insurance Operations Senior Claims Analyst
      • Oct 2018 - Apr 2021

      Processing/Auditing Medicare Advantage claims for Blue Cross Blue Shield products through Vizient/Advantasure using the IKA claims platform.Self-managed environment and self-paced with a daily quota.• Meeting personal SLA• Assisting with complex/unexpected matters• Auditing for financial and process accuracy – Subject Matter Expert• Exceeding monthly goals from leadership on monthly reviews• Processing on average 9,000 – 13,000 claims monthly• Analyzing & Reporting Claims Data & Trends

  • Baylor Scott & White Health
    • United States
    • Hospitals and Health Care
    • 700 & Above Employee
    • Access Service Representative II Team Lead
      • Jan 2018 - Oct 2018

      Patient Access Team Lead for Radiology facility. Coordinating with hospital staff.Directing patient access representatives on day to day operations.• Facilitating a positive environment for patients and staff• Performing Scheduling, registration, billing, collections, obtaining physicianorders, pre-certification, and insurance verification for patients.• Training new patient access reps, Provided coaching opportunities• Created training/learning process document requirements for new hires

  • UnitedHealth Group
    • Hospitals and Health Care
    • 700 & Above Employee
    • Resolution Support Specialist Tier 2
      • May 2015 - Nov 2017

      Handling Medicare Advantage and Medicaid members and claims. Self-managed working from home, handling high call volume inbound calls. Assisting with training opportunities and help-desk assistance for new hires in customer service.• National escalation team – De-escalating calls, Provided training/coaching• Claims processing/research, Assisting with Several Projects and ExceedingExpectations and Deadlines Handling Medicare Advantage and Medicaid members and claims. Self-managed working from home, handling high call volume inbound calls. Assisting with training opportunities and help-desk assistance for new hires in customer service.• National escalation team – De-escalating calls, Provided training/coaching• Claims processing/research, Assisting with Several Projects and ExceedingExpectations and Deadlines

Education

  • Jefferson Community College, Kentucky
    Associate of Science - AS, Health Services/Allied Health/Health Sciences, General
    2017 - 2020

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