Alexandra Taylor
Dallas ,TX
Summary
Results-driven healthcare administrative professional specializing in claims processing, customer service, and clinical data management. Excels in documentation review, record maintenance, and issue resolution. Coordinates effectively with patients, providers, and departments to ensure regulatory compliance and deliver timely support in fast-paced environments.
Overview
2027
2027
years of professional experience
Work History
Clinical Administrative Coordinator
UnitedHealth Group
03.2025 - Current
- Investigated and resolved complex benefit authorization and claims inquiries accurately, ensuring timely access to necessary services.
- Partnered with cross-functional teams to streamline claims processes, reducing processing time and enhancing member experience.
- Conducted proactive outreach to inform members about post-discharge benefits and healthcare resources, improving member engagement and resource utilization.
- Drafted and distributed detailed communications to members, ensuring compliance with documentation standards.
Administrative Assistant
Optum
03.2023 - 08.2025
- Acted as primary contact for providers and members, facilitating authorization requests and resolving claims inquiries.
- Reviewed claims documentation for accuracy, escalating complex issues to ensure timely resolution.
- Maintained comprehensive records and conducted timely follow-up on pending cases to support efficient claims processing.
- Collaborated with cross-functional teams to expedite claim resolution and improve member satisfaction.
CVS SPECIALTY
CVS Specialty Pharmacy
2018 - 2023
- Investigated coverage and claims issues, identifying solutions that expedited processing and approvals.
- Collaborated with insurance carriers, pharmacies, healthcare providers, and patients to resolve discrepancies.
- Facilitated patient inquiries on insurance claims and medication benefits, contributing to improved customer satisfaction.
- Maintained accurate documentation while providing compassionate service in handling sensitive healthcare information.
Skills
- Claims processing
- Claims resolution
- Claims documentation
- Healthcare compliance
- Compliance problem solving
- Case management
- Cross-functional collaboration
- Member engagement
- Detail orientation
- Microsoft Office Suite
- Communication skills
- Case management
Timeline
Clinical Administrative Coordinator
UnitedHealth Group
03.2025 - Current
Administrative Assistant
Optum
03.2023 - 08.2025
CVS SPECIALTY
CVS Specialty Pharmacy
2018 - 2023