Wellness and healthcare professional xxxxxxth experience motivating, mentoring and educating key stakeholders.

  Self-starter xxxxxxth solid listening, verbal communication and interpersonal skills to identify and resolve problems.

  Achieved $3.2 million in total savings in 2016 for MTV and $6. 1 million for CAS, including helping team members lose more than 400 pounds.

  Promoted to positions of greater responsibility for consistently exceeding performance objectives.

  Analytical, xxxxxxth solid time management, organizational and attention to detail skills, including prioritizing tasks.

  Experience xxxxxxth well-being snapshot, associate experience survey and focus groups.

  Proficient xxxxxxth Microsoft Office Suite and SharePoint; OneNote; and CCP and MACESS workflow processes.

- Data Analysis - Problem Solving - Team Leadership

- Policies & Procedures - Process/Continuous Improvement - Process Mapping

- Root Cause Analysis - Organizational Development - Public Speaking

Humana Oct. 2005-Present

Prepay Specialist (Feb. 2014-Present)

  Assist claimants, providers and clients xxxxxxth problems or questions regarding their claims and/or policies, including processing and paying clinical claims.

  Leverage Associate Experience Survey feedback to better understand others.

  Encourage participation on the Network Resource Groups (NRG s).

Well-Being Champion (Feb. 2009-Present)

  Build and maintain relationships xxxxxxth associates, including while building and executing the Leader Mentor Program to increase engagement xxxxxxth co-workers.

  Lead associate engagement focus groups and leverage insights to achieve higher engagement levels.

  Supported co-workers xxxxxxth creating their own exercise and diet plans to help improve their health and lifestyle.

  Motivate associates to participate in 5K run/walks and walking challenges, as well as educational opportunities pertaining to nutrition and financial security, including a virtual 5K xxxxxxth more than 500 employees.

  Work xxxxxxth HR staff to educate associates about their health benefits.

Analyst (Jan. 2010-Feb. 2014) 

  Demonstrated strong leadership while assigning daily claim volume to other associates on the team.

  Leveraged Provider SinglePoint Plus (PSP) and Provider at a Glance (PAAG) to review provider contracts along xxxxxxth live claims to ensure provider payment accuracy.

  Created Prepay rules on both MTV and CAS to suspend claims for review and used CAS and MTV to process and release claims from Prepay suspense status.

Humana (continued) Oct. 2005-Present

Analyst (Jan. 2010-Feb. 2014) 

  Participated in onsite audit for HCA Florida to determine potential Prepay opportunities.

  Built process workflows such as Gross Pay Process that proved vital in improving departmental processes.

Claims Processing Specialist (Feb. 2008-Jan. 2010) 

  Worked closely xxxxxxth providers and assisted xxxxxxth billing questions, including determining claims payment based on provider contracted rates.

  Analyzed claims billing on CMS-1500 and UB-92 forms and provider contracts.

  Verified member benefits using benefit plan documents and also verified claim payment accuracy.

  Contributed to continually improving processes in the department.

Billing/Cash Posting Specialist (Jan. 2007-Feb. 2008) 

  Communicated effectively xxxxxxth third party administrators when researching customer payments.

  Handled reconciliation and collection of accounts, as well as processing refunds.

Call Center Representative (Oct. 2005-Jan. 2007) 

  Educated customers, providers and employers over the telephone about company products and services.

  Demonstrated stellar listening skills to identify and resolve problems.

Exempla Health 1999-2005
Senior Financial Analyst

  Showcased expertise of general and cost accounting; financial statements; and operating and capital budgets.

Children s Hospital 1984-1999
Lead Financial Counselor

  Assisted families applying for financial aid through state-funded programs.

Master of Science (MS), Healthcare/Business Management, University of Phoenix

Bachelor of Science (BS), Healthcare/Business Management, University of Phoenix

  Business Analyst studies, Northwest Xxxxxx Technical College; currently attending

  Completed Managing Communications in a Virtual Team; Organization and HR: Employee Relations; Communication Skills and Project Management; and Written Communication courses.

NEW Zoo and American Red Cross