Brittany Shabez
Estero,FL
Summary
Dedicated and results driven Senior Claims Analyst with a proven track record at Union One Group Benefits Administration, enhancing claims processing efficiency by 30%. Expert in policy interpretation and adept in conflict resolution. I bring a blend of critical thinking and exceptional interpersonal skills to achieve high customer satisfaction and operational excellence.
Overview
12
12
years of professional experience
Work History
Senior Claims Analyst
Union One Insurance Group
Lake Barrington (Remote), IL
09.2021 - Current
- Reviewed, researched and evaluated customer claims to determine coverage under policy provisions or applicable laws.
- Managed workload effectively to ensure timely processing of claims within designated deadlines.
- Gathered proper documentation and data to prepare claims for submission.
- Conducted training sessions for new hires on claims processing and company protocols.
- Coordinated with external adjusters and experts for claims requiring specialized evaluation.
- Developed business relationships with clients to ensure satisfaction with services provided.
- Input claim information and payments into company database.
- Documented all claims activities clearly and concisely in the claims management system.
- Maintained confidentiality of claimant information in accordance with privacy laws and regulations.
- Prepared detailed reports summarizing claims outcomes and trends for management review.
- Supported policyholders through the claims process, providing exceptional customer service.
- Provided technical guidance to junior analysts regarding interpretation of contracts and other related matters.
- Performed administrative tasks such as filing paperwork, responding to emails and calls.
- Participated in claims audit processes to ensure compliance with internal and external standards.
- Communicated with policyholders to explain claims processes, coverage, and decisions.
- Assisted in the development and implementation of claims procedures to improve efficiency.
Business Assistant
Heartland Dental
Schaumburg, IL
07.2017 - 09.2021
- Completed thorough opening, closing, and shift change functions to maintain operational standards each day.
- Maintained patient records, scheduled appointments, and handled billing inquiries.
- Coordinated with dental providers regarding patient care and scheduling needs.
- Scheduled patient appointments and effectively handled cancellations and last-minute adjustments.
- Obtained maximum reimbursement by following up on unpaid claims and reviewing monthly aging reports.
- Efficiently managed collections and receivables, referrals process and billing to meet revenue goals.
- Charged expenses to accounts and cost centers by analyzing invoice and expense reports.
- Maintained relationships with third party payers in order to obtain timely payment on submitted claims.
- Responded promptly to inquiries from patients, providers, and insurers regarding claim status.
- Verified accuracy of information and resolved discrepancies with vendors before entering invoices for payment.
- Tracked overdue payments from insurance companies to ensure prompt reimbursement.
- Prepared detailed financial reports outlining accounts receivable status for each provider and insurer combination.
- Conducted regular audits of insurance billing to ensure accuracy and compliance.
- Collected, posted and managed patient account payments.
- Verified patients' insurance eligibility and benefits prior to appointments and procedures.
- Maintained accounting ledgers by verifying and posting account transactions.
- Participated in workshops, seminars, and training classes to gain stronger education in industry updates and federal regulations.
- Ensured timely filing of insurance claims to avoid lapses and penalties.
Treatment Coordinator
Compassionate Dental Care
Algonquin, IL
12.2016 - 07.2017
- Ensured compliance with HIPAA regulations as well as other applicable laws.
- Coordinated with insurance companies to confirm patient coverage and process claims.
- Scheduled evaluations and procedures for patients.
- Coordinated patient referrals to specialists and other healthcare services.
- Organized and led patient care meetings with healthcare teams to discuss treatment plans.
- Implemented patient care coordination programs aimed at improving patient health outcomes.
- Answered customer questions regarding account discrepancies or problems.
- Wrote appeal letters to insurance companies for denial of claims.
- Generated invoices for services rendered and sent them out according to established timelines.
- Prepared monthly statistical reports for management review.
- Arranged debt repayment or established schedules for repayment based on customer's financial situation.
- Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions.
Assistant General Manager
Jimmy John's
Cary, IL
11.2012 - 12.2016
- Conducted regular staff meetings to communicate goals, updates, and receive feedback.
- Ensured compliance with all applicable laws and regulations related to employment practices.
- Participated in recruitment, interviewing, and hiring processes to build a strong team.
- Handled customer complaints and inquiries, ensuring high levels of satisfaction.
- Prepared staff work schedules and assigned team members to specific duties.
- Ensured compliance with health and safety regulations to maintain a safe working environment.
- Prepared and analyzed financial reports to inform budgeting and financial planning.
- Controlled business inventory to keep numbers beneath targets through expert oversight and usage monitoring.
- Maintained accurate records of employee attendance, payroll information, sales figures.
- Communicated regularly with suppliers regarding product delivery timelines, pricing information.
- Monitored inventory levels and ordered supplies to maintain optimal stock.
Education
High School Diploma -
Cary Grove
Cary, IL01-2010
Skills
- Claims processing efficiency
- Interpersonal and written communication
- Critical thinking
- Policy interpretation proficiency
- Professionalism and integrity
- Member Advocacy
- Conflict resolution
- Communication and negotiation
- Mediation and dispute resolution
References
References available upon request.
Timeline
Senior Claims Analyst
Union One Insurance Group
09.2021 - Current
Business Assistant
Heartland Dental
07.2017 - 09.2021
Treatment Coordinator
Compassionate Dental Care
12.2016 - 07.2017
Assistant General Manager
Jimmy John's
11.2012 - 12.2016
High School Diploma -
Cary Grove
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