Anita Crooks
Toms River,NJ
Summary
Versatile Coaching Specialist with results-driven and focused approach to completing work. Skilled leader, planner and problem-solver with 34-year career in healthcare insurance. Dependable with track record of success in field, attention to detail and proactive mindset. Seeks opportunities to improve development of staff, processes and workflows for company benefit. Conscientious, hardworking and excels at multitasking in fast-paced environments.
Overview
26
26
years of professional experience
Work History
Coaching Specialist I
Horizon Blue Cross Blue Shield of NJ
Wall, NJ
06.2008 - Current
- Participated in ongoing training and compliance activities.
- Coordinated with other departments to ensure efficient workflow processes.
- Conducted regular meetings with staff to review progress and address any concerns.
- Provided technical support for customers in resolving complex issues.
- Leveraged specialized knowledge to act as subject matter expert within organization.
- Generated reports to track performance metrics of team members.
- Identified opportunities to enhance specialization resulting in increased efficiency.
- Assisted in developing strategies to increase customer satisfaction levels.
- Researched and analyzed customer feedback to identify areas of improvement.
- Analyzed data from customer surveys to identify trends in customer behavior.
- Maintained positive working relationship with fellow staff and management.
Senior Member Service Coordinator
Horizon Blue Cross Blue Shield of NJ
Wall, NJ
06.2006 - 06.2008
- Delegated work to staff, setting priorities and goals.
- Resolved customer complaints or answered customers' questions.
- Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs.
- Coordinated with other supervisors, combining group efforts to achieve goals.
- Guided employees in handling difficult or complex problems.
- Discussed job performance problems with employees, identifying causes and issues to find solutions.
PG/NJ Transit Dedicated Team
Horizon Blue Cross Blue Shield of NJ
Wall, NJ
01.2005 - 06.2008
- Relationships with Account Management Team and Group Administration Staff.
- Dedicated to handling the NJ Transit FELA members to ensure the members are enrolled timely and claims are processed accurately.
- Cross trained on multiple products.
- Supported newer Call Center Agents with questions and escalations.
Member Service Consultant
Horizon Blue Cross Blue Shield of NJ
Wall, NJ
11.2002 - 01.2005
- Respond to member claims and benefit inquiries.
- Perform claim adjustments.
Medical Billing Specialist
Pediatric Affiliates P.A.
Toms River, NJ
09.2002 - 11.2002
- Insurance followup of submitted claims.
- Verification of eligibility and benefit coverage.
- Post insurance payments.
- Preparation of billing statements.
- Monitor capitation payments.
Customer Resolution Consultant
Aetna
Cranbury, NJ
01.1998 - 10.2001
- Respond to Department of Insurance Complaints.
- Address provider/member complaints, appeals, grievances.
- Verification of pre-certifications.
- Assist in associate training.
- Quality review of processed claims.
- Examine and process medical claims.
- Respond to telephone inquiries.
Education
Certification - Religious Education-Teachers Training
Eastern Bible Institute
Newark06-2004
Some College (No Degree) - Business Administration And Management
Trenton State College
Ewing, NJ05-1983
High School Diploma -
Lakewood High School
Lakewood, NJ06-1981
Skills
- Customer Relations
- Task Prioritization
- Time Management
- Decision-Making
- Effective Communication
- Teamwork and Collaboration
- Problem-Solving
- Data Analysis
- Professionalism
- Active Listening
- Interpersonal Skills
- Organizational Skills
- Multitasking
- Issue Research
- Relationship Building
- Written Communication
- Continuous Improvement
- Team Collaboration
- Analytical Skills
- Attention to Detail
- Reliability
- Adaptability and Flexibility
- Experience in Leadership
- Self Motivation
Accomplishments
- Named to Horizon Blue Cross Blue Shield of New Jersey 85th Anniversary Hall of Fame 10/12/2017
Timeline
Coaching Specialist I
Horizon Blue Cross Blue Shield of NJ
06.2008 - Current
Senior Member Service Coordinator
Horizon Blue Cross Blue Shield of NJ
06.2006 - 06.2008
PG/NJ Transit Dedicated Team
Horizon Blue Cross Blue Shield of NJ
01.2005 - 06.2008
Member Service Consultant
Horizon Blue Cross Blue Shield of NJ
11.2002 - 01.2005
Medical Billing Specialist
Pediatric Affiliates P.A.
09.2002 - 11.2002
Customer Resolution Consultant
Aetna
01.1998 - 10.2001
Certification - Religious Education-Teachers Training
Eastern Bible Institute
Some College (No Degree) - Business Administration And Management
Trenton State College
High School Diploma -
Lakewood High School
Similar Profiles
Shawnette CulverShawnette Culver
Claims Operations Analyst at Horizon Blue Cross Blue Shield of NJClaims Operations Analyst at Horizon Blue Cross Blue Shield of NJ
Regina XhezoRegina Xhezo
Integration Lead at Horizon Blue Cross Blue Shield of NJIntegration Lead at Horizon Blue Cross Blue Shield of NJ
Shakira StewartShakira Stewart
Mentor at Horizon Blue Cross Blue Shield Of NJMentor at Horizon Blue Cross Blue Shield Of NJ