Summary
Overview
Work History
Education
Skills
Timeline
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Brittny Wlson

Joliet,IL

Summary

A self-directed support professional with demonstrated performance in customer service, problem-solving, time management and organizational skills. I am seeking to be able to implement independent, in a team setting, decisions to achieve both immediate and long-term goals with sound decision-making and interpersonal skills.

Overview

8
8
years of professional experience

Work History

Program Coordinator

Centene, Superior Health Services
10.2022 - Current
  • Developed effective communication strategies for improved collaboration among team members, resulting in increased productivity.
  • Coordinated cross-functional teams to ensure timely completion of program deliverables.
  • Led training sessions for staff and volunteers, fostering a knowledgeable and cohesive team environment.
  • Maintained detailed records of program activities and participant data, ensuring compliance with internal policies and external regulations.
  • Provided exceptional customer service to program participants through prompt response times and attentive assistance with inquiries or concerns.


Claims Technician

The Hartford
09.2017 - 10.2022
  • Investigated medical only claims and determine compensability in accordance with applicable statute, case law and experience.
  • Reviewed, analyzed and documented medical treatment to track progression of injured workers recovery and ensure treatment is appropriate.
  • Established and maintained appropriate reserves in accordance with department policies and procedures.
  • Communicated with outside attorneys to resolve areas of dispute and negotiate appropriate and timely settlements.
  • Provided quality customer service, and project positive corporate image.
  • Maintained accurate and detailed claims documentation.
  • Prepare timely and appropriate file reviews as requested.
  • Utilized staff resources to assist in efficiency of daily work.
  • Performed other duties as requested.
  • Enhanced internal customer satisfaction by promptly addressing and resolving claims issues.

Sr. Representative/Claims, Member & Provider Rep

Molina Healthcare Inc
11.2015 - 09.2017
  • Reviewed medical claims for accuracy of procedure and diagnosis codes
  • Assisted providers in explaining Prior Authorizations approvals and denials
  • Maintained individual performance goals as it relates to call center objectives
  • Received inbound calls from members about their benefits
  • Updated member information as necessary
  • Assisted member with scheduling appointments as requested
  • Increased customer satisfaction by promptly addressing concerns and providing effective solutions.
  • Strengthened client relationships through excellent communication skills and consistent followup.

Education

Associate of Applied Science - General Studies

Joliet Junior College
Joliet, IL
12.2006

Skills

  • Training Development
  • Performance Measurement
  • Cross-functional Collaboration
  • Problem Solving
  • Time Management
  • Decision-Making
  • Critical Thinking
  • Dependability and Cooperation
  • Microsoft Office Suite
  • Multi-Line Phone System

Timeline

Program Coordinator

Centene, Superior Health Services
10.2022 - Current

Claims Technician

The Hartford
09.2017 - 10.2022

Sr. Representative/Claims, Member & Provider Rep

Molina Healthcare Inc
11.2015 - 09.2017

Associate of Applied Science - General Studies

Joliet Junior College

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Brittny Wlson