Alicia Hlabangana
Bedford Heights
Summary
Dynamic Senior Claims Processor with extensive experience at Medical Mutual of Ohio, recognized for exceeding quality benchmarks and enhancing departmental efficiency. Proficient in Medicare Advantage claims and compliance with CMS guidelines, while demonstrating exceptional attention to detail and mentorship abilities. Proven track record of delivering accurate results in high-pressure environments.
Overview
32
32
years of professional experience
Work History
Senior Claims Processor, Temporary
Medical Mutual of Ohio
Cleveland
02.2025 - Current
- Processed Medicare Advantage and employee claims with precision and compliance.
- Enhanced departmental output during high-demand periods.
- Kept current with claim processing systems and procedures.
- Achieved consistently accurate and productive results.
Senior Claims Representative (Medicare Advantage & Employee Medical Claims)
Medical Mutual of Ohio
Cleveland
01.2017 - 07.2024
- Handled complex Medicare Advantage and employer-sponsored medical claims.
- Collaborated with internal teams to resolve issues and support special projects.
- Trained junior staff and contributed to process improvement initiatives.
- Recognized for consistently exceeding quality and efficiency benchmarks.
Medical Claims Processor
Medical Mutual of Ohio
Cleveland
01.2015 - 01.2017
- Transitioned from dental to medical claims seamlessly.
- Applied knowledge of coordination of benefits, provider billing, and medical terminology.
- Maintained top-tier performance metrics while adapting to new claim types.
Senior Dental Claims Representative
Medical Mutual of Ohio
Cleveland
01.1995 - 01.2015
- Processed and reviewed dental claims, specializing in high-dollar and complex cases.
- Served as a mentor to new hires and provided quality checks for team members.
- Set the gold standard for claim accuracy and turnaround time.
Claims Service Representative (Dental Claims)
Medical Mutual of Ohio
Cleveland
11.1993 - 01.1995
- Specialized in dental claims processing and supported day-to-day claim resolution.
- Contributed to service quality improvements and team collaboration.
- Performance consistently ranked in the top tier within the department.
Claims Support Specialist
Medical Mutual of Ohio
Cleveland
08.1993 - 11.1993
- Handled initial intake and entry of all claim types.
- Ensured accuracy in documentation and routing of claims to appropriate departments.
- Supported a high-volume claims environment with precision and efficiency.
Education
High School Diploma -
Regina High School
South Euclid, Ohio06-1990
Skills
- Medicare Advantage and Commercial Claims
- Coordination of Benefits (COB)
- CMS Guidelines Compliance
- Dental and Medical Terminology
- Claims Software and Systems
- Attention to Detail
- Training and mentorship
- Customer Service and Communication
- Adaptability and flexibility
Additional Information
Consistently achieved high performance results in every position, often surpassing quality and productivity expectations., Repeatedly selected to assist in departmental training and special projects.
Timeline
Senior Claims Processor, Temporary
Medical Mutual of Ohio
02.2025 - Current
Senior Claims Representative (Medicare Advantage & Employee Medical Claims)
Medical Mutual of Ohio
01.2017 - 07.2024
Medical Claims Processor
Medical Mutual of Ohio
01.2015 - 01.2017
Senior Dental Claims Representative
Medical Mutual of Ohio
01.1995 - 01.2015
Claims Service Representative (Dental Claims)
Medical Mutual of Ohio
11.1993 - 01.1995
Claims Support Specialist
Medical Mutual of Ohio
08.1993 - 11.1993
High School Diploma -
Regina High School