Nedra Rogers
Columbus,GA
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
16
16
years of professional experience
Work History
Remote- Claims Analyst II
CorroHealth
06.2022 - Current
- Demonstrate Company’s Core Competencies and values held within
- Review submitted claim documents for sufficient data, verifies that benefits were paid correctly and in accordance with appropriate plans and policies
- Responsible for documenting and tracking results in designated format and timeframes
- Assist manager in identifying trends, weaknesses, and strengths for insight to the team's quality and understanding of the work
- Includes developing training materials, and conducting training sessions with staff
- Assist supervisor with system procedures relating to adjustments, voids, cancellations, or reimbursements
- Communicate with Accounting regarding returned claims checks - due to wrong address info; as requested by the Claims department; or as submitted due to provider corrections
- Recommend changes to the Claims Procedural manual
- Update manual as necessary with changes
- Verify quality assurance and prepare claim files for submission
- Sorting and filing claims and errors in an organized manner
- Computer savvy-creating, moving, submitting files and folders
- Tracking errors to sure all claims are corrected and sent out
- Clearinghouse: Upload claim files
- Troubleshoot software error reports, clearinghouse rejections, etc
- Meticulous record keeping including electronic claim files
- Research, identify and obtain data / information needed to help accurately interpret the data as needed
- Medical claims adjudication and / or medical claim customer service experience with exposure to
- Coordination of Benefit (COB) and / or interpretation of Explanation of Benefits (EOB)
- Data analysis experience (finding trends in data including plans, products, and network rate differentials)
- Maintained strict confidentiality with all personal data as per company guidelines.
Dispatch Manager
VanRogers Trucking
08.2021 - Current
- Organized and coordinated dispatch training programs for new hires and refresher training programs for existing personnel to continuously promote company vision, values and culture.
- Motivated staff to deliver high-level dispatch support while successfully meeting departmental goals.
- Recruited, interviewed and selected employees in compliance with hiring practices and minimum standards of qualification and recommended personnel for promotion, demotion or reclassification to meet staffing requirements.
- Conferred with customers to address questions, problems and requests for service or equipment to allocate dispatch coverage during peak service times and during employee shortages.
Sr Member Service Representative III
Navy Federal Credit Union
05.2016 - 08.2021
- Investigate fraudulent transactions in branch, ATM, over the phone for members
- Process fraud claims, process new debit cards, using VISA network reviewing unauthorized transactions, approving fraud prevention transactions by calling the member to ensure it’s a true transaction
- Served as a Branch Office and/or ATM vault custodian ensuring the vault and ATM is balanced daily
- Perform other duties as assigned notaries , printed and signing loan documents, printing instant debit cards and many other duties
- Analyze, research, and resolve problems and discrepancies related to member accounts/loans
- Initiate new employee payroll and interface with human resources to activate enrollment in benefits packages
- Recruiting: job posting and pre-screening for middle management positions
- Assist members with completing consumer/mortgage/equity loan, overdraft protection and credit card applications
- Counsel current and prospective members about Navy Federal's products and services
- Ensure cash and other negotiable instruments are handled properly
- Identify opportunities to cross service products and increase product penetration
- Perform platform banking functions
- Understand and comply with federal and other regulations relating to financial products and services
- Assisted with Branch Office vault opening, closing and balancing procedures
- Promoted to Assistant Bank Manager
- Supervised associates, team members, employees and staff members
- Managed bank operations
- Managed opening and closing bank
- Managed nightly register, financial and cash totals
- Managed daily reports of transactions
- Rearranged and detailed bank merchandise according to company standards
- Recruited and interviewed potential candidates
- Handled all team member, employee and staff member scheduling
- Enforced company policies and procedures
- Assisted members with correcting account, service and system issues by educating on required forms and technical processes.
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
Remote Claims Representative III
Blue Cross Blue Shield of Georgia, ANTHEM
04.2013 - 01.2017
- Enters and sorts of daily patient logs using MS Excel and various systems
- Creates correspondence in MS Word
- Operates various types of equipment for purposes of scanning claims, correspondence, and other related documents
- Research and correct patient charts and documented information in various company software
- Oversee legal and medical aspects of claims
- Document claim file activities in accurate and timely manner
- Resolve claim issues promptly and follow-up on outstanding issues
- Perform negotiation with insured and claimant to achieve claim settlements
- Communicate claim status to supervisor and customers on regular basis
- Contact outside agents for claim investigation if needed
- Remote
- No work history none
- Interviewed policyholders to verify information and obtain additional details.
- Examined reports, accounts and evidence to determine integrity and accuracy of information.
Lead Teller
Wells Fargo Bank
03.2007 - 01.2012
- Maintained optimal financial controls by securing funds and making accurate transactions
- Verified amounts and integrity of every check or funds transfer
- Promoted facility security by monitoring customer behaviors and following established protocols to protect individuals and assets
- Conducted special service and account transactions for customers, including ordering checks and placing stop payment orders
- Met or exceeded sales goals by promoting bank products and services
- Completed monthly audits and managed overdraft reports
- Adhered to strict guidelines regarding financial and customer data to avoid breaches and information misuse
- Performed basic administrative tasks regarding banking products, including handling phone calls, inquiries, and emails
- Increased knowledge of banking products and services by actively participating in available training classes and workshops offered to employees
- Opening and Closing of the branch
Education
Associate's - Human Resource Management
Columbia College
Skills
- Leadership
- Coverage Determination
- Claims Review
- Service Quality
- Customer Retention
- Claims
- Accounts Payable and Accounts Receivable
- Customer Satisfaction
- Interpersonal and Written Communication
- Data Entry Software
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Additional Information
- Willing to relocate to: Atlanta, , GA - - , Authorized to work in the US for any employer
Quote
There is a powerful driving force inside every human being that, once unleashed, can make any vision, dream, or desire a reality.
Tony Robbins
Timeline
Remote- Claims Analyst II
CorroHealth
06.2022 - Current
Dispatch Manager
VanRogers Trucking
08.2021 - Current
Sr Member Service Representative III
Navy Federal Credit Union
05.2016 - 08.2021
Remote Claims Representative III
Blue Cross Blue Shield of Georgia, ANTHEM
04.2013 - 01.2017
Lead Teller
Wells Fargo Bank
03.2007 - 01.2012
Associate's - Human Resource Management
Columbia College
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