Amanda Beck
Greenville,Texas
Summary
Analytical professional with technical knowledge and critical thinking skills to thrive in data-driven environments. Tackles challenges with positivity and drive to overcome. Works great alone or with others and consistently exceeds expectations. Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
15
15
years of professional experience
Work History
OON Vendor Negotiation Analyst
United Healthcare Group
Richardson, TX
06.2016 - Current
- Interpreted and interrelated research data to develop integrated business analysis and projections.
- Reported on common sources of technical issues or questions and made recommendations to product team.
- Synthesized multiple sources of data and large data sets to develop reports, tools and metrics.
- Determined operational objectives by studying business functions and evaluating output requirements and formats.
- Maintained positive working relationship with fellow staff and management.
- Identified needs of customers promptly and efficiently.
- Set specific goals for projects to measure progress and evaluate end results.
- Identified areas for improvement, narrowing focus for decision-makers in making necessary changes.
- Monitored operations and reviewed records and metrics to understand company performance.
- Assessed company operations for compliance with safety standards.
- Utilized document management system to organize company files, keeping up-to-date and easily accessible data.
- Implemented strategies to take advantage of new opportunities.
- Integrated standardized tools and templates to streamline cross-functional project management.
Life Insurance Customer Service Representative
Torchmark Corporation
McKinney, TX
09.2014 - 06.2016
- Answered customer inquiries and provided accurate information regarding products and services.
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Maintained detailed records of customer interactions, transactions and comments for future reference.
- Performed administrative tasks such as filing paperwork, updating databases and generating reports.
- Resolved complex problems by working with other departments to provide solutions that meet customer needs.
- Identified areas of improvement in customer service processes and suggested changes accordingly.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions.
- Answered inbound calls, chats and emails to facilitate customer service.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- Demonstrated excellent communication skills in resolving product and consumer complaints.
- Provided outstanding service to new and long-standing customers by attending closely to concerns and developing solutions.
- De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
- Consulted with customers to resolve service and billing issues.
- Escalated customer concerns, issues and requirements to supervisors for immediate rectification.
- Informed customers about billing procedures, processed payments and provided payment option setup assistance.
- Fielded customer complaints and queries, fast-tracking for problem resolution.
- Used proven techniques to de-escalate angry customers during telephone interactions.
- Made outbound calls to obtain account information.
- Improved customer service wait times to mitigate complaints.
- Mentored new employees on procedures and policies to maximize team performance.
- Engaged in conversation with customers to understand needs, resolve issues and answer product questions.
- Enhanced productivity and customer service levels by anticipating needs and delivering outstanding support.
- Kept records of customer interactions or transactions, thoroughly recording details of inquiries.
- Collected deposits or payments and arranged for billing.
- Referred unresolved customer grievances to designated departments for further investigation.
Medical Claims Adjuster
Cigna
Denison, TX
05.2009 - 07.2014
- Reviewed medical records to determine the appropriateness of services rendered and billed by healthcare providers.
- Analyzed medical claims for accuracy, completeness, and compliance with company policies and procedures.
- Investigated discrepancies in medical billing codes, patient information, and other data related to claims processing.
- Resolved complex claim issues through research, negotiation, and collaboration with other departments.
- Assessed claim denials to determine if appeals are appropriate.
- Documented all decisions made on claims in accordance with established guidelines.
- Provided customer service support to healthcare providers regarding denied or disputed claims.
- Identified trends in claim rejections or denials and provided feedback to management team.
- Verified that payments were made according to contracted terms between provider and insurer.
- Reconciled rejected claims using automated adjudication software systems.
- Participated in training sessions designed to keep current on industry-specific regulations.
- Stayed current on HIPAA regulations, benefits claims processing, medical terminology and other procedures.
- Accurately processed large volume of medical claims every shift.
- Inputted data into the system, maintaining accuracy of provider coding information and reported services.
- Sent clinical request and missing information letters to obtain incomplete information.
- Based payment or denials of medical claims upon well-established criteria for claims processing.
- Tracked differences between plans to correctly determine eligibility and assess claims against benefits and data entry requirements.
Education
Some College (No Degree) -
Grayson College
Denison, TXSkills
- Documentation And Reporting
- Information Gathering
- Report Preparation
- Regulatory Compliance
- Workflow Analysis
- Issue Identification
- Bookkeeping
- Account Reconciliation
- MS Excel
- Excel proficiency
- Continuous Improvement
- Machine Learning
- Analytical Thinking
- Deadline Adherence
- Data Research and Validation
- Compliance Analysis
- Process Improvements
- Multiple Priorities Management
- Data Collection
- Paperwork Processing
- Account updating
- Documentation
- Positive and professional
- Active Listening
- Customer Education
- Customer Service
- Office equipment proficiency
- Spreadsheets
- Microsoft Office expertise
- Customer Relationship Management (CRM)
- Account Management
- Grammar
- Payment Processing
- Document Control
- Problem Resolution
- De-Escalation Techniques
Timeline
OON Vendor Negotiation Analyst
United Healthcare Group
06.2016 - Current
Life Insurance Customer Service Representative
Torchmark Corporation
09.2014 - 06.2016
Medical Claims Adjuster
Cigna
05.2009 - 07.2014
Some College (No Degree) -
Grayson College