Experience

Cigna Healthcare

• Hospitals and Health Care
• 700 & Above Employee

• Operating Effectiveness Sr. Advisor

  • Oct 2020 - Present

• Operations Senior Specialist

  • Jun 2016 - Oct 2020

• Resource Planning Specialist

  • Jul 2014 - Jun 2016

  Direct management responsibility for 14 Resource Planning Senior Associates that included coaching, training, performance management, and appraisals.Managed inventory and aging for key Medical and Dental claim accountsCollaborated with other Resource Management teams to ensure successful transition of inventory and aged claims

• Claims Specialist- Proclaim

  • Jan 2013 - Jul 2014

  Training manager aligned to new hire training classes on the Proclaim platform. Responsible for onboarding new hires and managing training classes.Direct management responsibility for 8 claim processors that includes coaching, training, performance management, and appraisals.Manage production and quality results for claim processor team.Collaborate with internal partners to insure maximum efficiency with claim processing, address, and correct process gaps to achieve department goals.

• Claims Specialist

  • Jul 2011 - Jan 2013

  Direct management responsibility for 21 claim processors with 6 employees off site that includes coaching, training, performance management, and appraisals.Manage daily inventory and production results for claim processor team.Collaborate with internal partners to insure maximum efficiency with claim processing, address, and correct process gaps to achieve department goals.

• Claims Supervisor

  • Mar 2010 - Jun 2011

  Managed team of nine claim processors that included regular employee meetings, coaching, implementation of development action plans, and end of year evaluations.Executed on timely and accurate completion with employee on-boarding, transfer, and process terminations for contract employees.Supervised Medicare contract transition activities and insured 100% of claim deliverables submitted timely which required collaboration with cross-functional teams.Facilitated active engagement and communication with senior leadership and respective project teams for Medicare contract transition.

• Overpayment Recovery Analyst

  • Feb 2009 - Feb 2010

  Processed adjustments in Non-MSP correspondence Trained to process Appeals Notifications, Undeliverables, Unsolicited Responses and MSP Correspondence

• Claims Processor

  • Sep 2007 - Feb 2009

  Trained to process Front End and MSP claims Performed HPSA monitoring duties on a quarterly basis from January 2008 until March 2010 Conducted extensive research to complete monitoring report Frequently interacted with providers during the monitoring process Consistently produced the report ahead of the scheduled due date for CMS