Experience

Catalyst Solutions

• Financial Services

• Claims Analyst

  • Mar 2023 - Present

  Demonstrate expertise in claims processing and adjudication regarding payment methodologies and reimbursement rules for Medicaid and Medicare clients. Experience working with Facets, Tableau, Looker, Guiding Care, eCW, and Microsoft Office products.Review claims flagged needing prior authorization review for necessary approvals and utilization.Assist our client in transitioning from PCG claims software to Cognizant (TMG) BPaaS Solution on Facets as a Consultant on the Client Engagement Team. Show less

• Claims Examiner II

  • Sep 2022 - Mar 2023

  Participated in classroom trainings regarding compliance and the Healthcare industry. Assigned to process improvement documentation project. Created Visio flow chart drawings of SOP's on behalf of our client.



UPMC Health Plan

• United States
• Insurance
• 700 & Above Employee

• Senior Claims Examiner

  • Sep 2021 - Sep 2022

  TPA Claims adjustment and processing for CCBH team within set quality and production standards.

• Claims Examiner

  • Jun 2020 - Apr 2022

  As a member of the TPA Services team review CCBH claims and verify accuracy for payment and/or claims denial. Maintain efficient production levels and quality.



CVS Health

• United States
• Wellness and Fitness Services
• 700 & Above Employee

• Customer Service Representative

  • Aug 2019 - Apr 2020

  Answered incoming customer calls regarding their prescription benefits coverage. Focused on medicaid of NY and Carefirst insurances as well as commercial policies at a national level. performed outgoing calls to doctors offices and pharmacies. Filed grievances on behalf of members. Answered incoming customer calls regarding their prescription benefits coverage. Focused on medicaid of NY and Carefirst insurances as well as commercial policies at a national level. performed outgoing calls to doctors offices and pharmacies. Filed grievances on behalf of members.



ARDEX Americas

• United States
• Wholesale Building Materials
• 200 - 300 Employee

• Quality Control Laboratory Technician

  • Mar 2016 - Feb 2019

  Quality control laboratory testing for Ardex and Henry powder products including all finished goods and raw materials. Product trend mapping and SOP writing/updating. Formula adjustment assistance. Responsible for maintaining Lab standards of temperature/humidity as well as safety and cleanliness. Trained several lab personnel and production team members. Traveled to assist other company labs in times of need. Quality control laboratory testing for Ardex and Henry powder products including all finished goods and raw materials. Product trend mapping and SOP writing/updating. Formula adjustment assistance. Responsible for maintaining Lab standards of temperature/humidity as well as safety and cleanliness. Trained several lab personnel and production team members. Traveled to assist other company labs in times of need.



Financial Dimensions

• Financial Services
• 1 - 100 Employee

• Recording Specialist

  • May 2013 - May 2014

  Within the Loan Servicing Department, review mortgage loan documents, evaluate county specific requirement costs for recording, request and attach payment for said documents. Research records of previously recorded mortgages to ensure accuracy of data. Coordinate nationally with counties to verify information. Within the Loan Servicing Department, review mortgage loan documents, evaluate county specific requirement costs for recording, request and attach payment for said documents. Research records of previously recorded mortgages to ensure accuracy of data. Coordinate nationally with counties to verify information.