Nationwide Health Plans, Sacramento, CA
Promotion: Manager, Member Services
Job Requirements & Accomplishments
Oversee operations related to Member eligibility and premium maintenance, records retention and handling of incoming/outgoing mail.
· Increased department’s overall efficiency and value by introducing cross-training and removal of redundant procedures across multiple departments
· Improved employee moral through positive coaching and professional growth support
· Established discounted corporate rates for services provided by California Overnight, FedEx and UPS.
CalFarm Insurance Company,
Promotion: Sr. Business Analyst
Job Requirements & Accomplishments
Work with a variety of personnel from functional areas, IT, and executive level management. Responsible for identifying and analyzing system issues, process deficiencies, prioritize assignment of work requests, quality assurance testing, gather business requirements, and bridge the communication gap between end users and IT.
· Attend annual Marketing Planning & Strategy conferences; providing expert consultation of system capabilities and high-level feasibility of planned activity.
· Created master reference document used by multiple production areas, IT, and analysts in multiple facilities.
· Spearheaded installation of online edits to prevent common user errors from occurring.
California Farm Bureau Federation,
Lead Processor / Supervisor Job Requirements & Accomplishments Process changes to member’s Certificates as dictated by Company Policy based on review of daily, weekly and monthly reports. Support customer change requests and complex adjustments. Responsible for ensuring all customers maintained their Farm Bureau membership, in accordance with the California Farm Bureau Federation and local County Farm Bureaus. · Supervised 4 night crew staff positions · Authorized to approve exceptions to Company Policy
Blue Shield of California, Marysville, CA
Claims Processor & Adjustor
Job Requirements
Respond to written and telephone inquiries from beneficiaries, care providers, medical insurance underwriters, and the Social Security Administration. Resolve processing errors, provide clarification of billing procedures, determine eligibility of proposed services, and answer general requests for information. Review initial appeals of denied claims and determined acceptance or denial of claim payment based upon additional information supplied.
Earned weekly incentive checks for exceeding production and quality standards.