Barbara Delton Jones
East Windsor,CT
Summary
Astute Claims Analyst with excellent claim processing and analytical skills. Highly effective at collaborating and working with peers, customers and other stakeholders. Known for efficiency and proactive, goal-oriented planning. An engaging individual with more than 20 years working as a Senior Claims Support Analyst for a top insurance company. Determined and effective in independent and team environments.
Responsible Cashier proficient in handling money, restocking merchandise and helping customers locate products. History of keeping work areas clean, neat and professionally arranged. Good listening skills combined with attentive and detail-oriented nature.
Bookkeeper well versed in payroll, accounts payable and accounts receivable functions. Exceptional bookkeeping, reporting and communications skills to improve efficiency and enable desirable outcomes.
Overview
27
27
years of professional experience
Work History
Senior Claims Support Analyst
Aetna, CVS Health
Hartford, CT
04.1994 - 11.2019
- Collected and tracked evidence in support of legal processes.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Provided primary customer support to internal and external customers.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Performed troubleshooting and maintenance of existing network systems.
- Worked effectively in both independent and team environments to exceed Team goals.
- Monitored, tracked and prioritized new work requests at Help Desk within set response times.
- Worked with various departments on integrating new processes for claim processing.
- Collaborated with upper management, claim processors, claim system mappers, customers to resolve any system issues causing advanced claim problems.
- Performed root cause analysis and general troubleshooting.
- Applied superior Aetna claims knowledge to improve claim processing procedures.
Cashier/Bookkeeper/Pharmacy Assistant
Richard's Drug Company
East Windsor, CT
01.1993 - 03.1994
- Kept pharmacy counter and related areas clean, neat and organized.
- Prepared bills for clients and submitted required paperwork to insurance companies.
- Answered telephones and provided information about order status, store hours and pharmacy procedures.
- Greeted customers and responded to questions with friendly, knowledgeable assistance.
- Operated cash register and performed front counter tasks to facilitate daily operations.
Education
High School Diploma -
East Windsor High School
76 S. Main Street, East Windsor, CT 06088-978406.1969
Skills
- Claims review
- Claims Processing
- Healthcare Common Procedures Coding System (HCPCS)
- Microsoft Word
- Microsoft Office Suite
- Issue and Complaint Resolution
- Creative Problem Solving
- Responding to Difficult Customers
- Multitasking and Prioritization
- Data Entry and Maintenance
- Building Customer Trust and Loyalty
- Understanding Customer Needs
- Calm and Professional Under Pressure
- Efficient and Detail-Oriented
- Upbeat and Positive Personality
- Verbal and Written Communication
- Courteous with Strong Service Mindset
- Proactive Self-Starter
- Cash Register Operations
- Credits and Refunds
Timeline
Senior Claims Support Analyst
Aetna, CVS Health
04.1994 - 11.2019
Cashier/Bookkeeper/Pharmacy Assistant
Richard's Drug Company
01.1993 - 03.1994
High School Diploma -
East Windsor High School
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