Andrea Dawn Browning

Claim Senior Representative

Cigna Healthcare Insurance

12.2012 - Current

Analyzed and addressed escalated claims to resolve issues quickly.
Worked productively in fast-moving work environment to process large volumes of claims.
Researched and analyzed complex claims to determine next steps and possible outcomes.
Updated claims system to track claim status and provide relevant information to other department.
Developed in-depth understanding of insurance policies and procedures to give accurate recommendations to suit clients' needs.
Negotiated claim settlements with claimants and compliance to resolve claims efficiently and fairly.
Updated field operations staff on status of open claims and current actions.
Collaborated with legal department on important claims.
Collaborated with internal departments and external vendors to achieve fast resolution of claims.
Maintained accurate and up-to-date records of claim information for future reference.
Examined reports, accounts, and evidence to determine integrity and accuracy of information.
Followed up with customers on unresolved issues.
Prepared and presented detailed reports to management on claims issues to aid in decision making.
Monitored and managed claim expenses to control costs and maximize profitability.
Maintained confidentiality of patient finances, records, and health statuses.
Checked documentation for accuracy and validity on updated systems.
Calculated adjustments, premiums and refunds.
Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
Posted payments to accounts and maintained records.