CANDICE RONDEAU
Bristol
Summary
Diligent Claims Analyst with a strong focus on exceeding performance targets through efficient work completion. Experienced in quality assurance with a solid foundation in problem-solving and analytical skills. Committed to enhancing business processes and delivering value through expertise in industry tools and methodologies.
Overview
27
27
years of professional experience
Work History
Overpayment Specialist
End-Game Strategy
Berlin
07.2004 - Current
- Review previously processed claims for many prominent insurance companies.
- Identify overpayments that were issued to providers.
- Handled appeals for insurance companies while still working on monthly productivity.
- Trained coworkers how to handle appeals using our company's appeal system.
- Maintain high production & quality standards.
- Communicate via email with clients on claim issues.
- Well versed on CPT, HCPCS and Revenue Codes. And ICD9 codes.
- Assisted in help documents in order to train new hires.
- Developed procedures and policies by devising strategies, consistently improving processes and supporting organizational goals.
Claims Analyst
Cigna Healthcare
Bristol
08.2000 - 07.2004
- Investigated claims using technical knowledge of the insurance company's requirements and the industry's standards.
- Processed high dollar claims, facility, surgical and physician.
- Adjusted previously processed claims via call center system.
- Handled escalated issues in a timely manner.
- Maintained quality and production standards.
Bank Teller
Webster Bank
Bristol
04.1999 - 08.2000
- Used expert sales and service abilities to consistently achieve sales and referral goals.
- Updated customer accounts with new balance, payment, and transfer information.
- Employed excellent money handling abilities to operate and balance cash drawer daily.
- Consistently met sales quotas by discussing bank products with customers, including loans, credit cards and lines of credit.
- Smoothly opened, closed and updated accounts and savings plans for customers.
- Maintained accurate and balanced cash drawers by carefully counting funds and quickly investigating any discrepancy.
Education
High School Diploma - general studies
Bristol Eastern High School
Bristol, CTSkills
- Claims processing
- Investigate claims
- Determine coverage
- CPT coding
- Analytical thinking
- Problem-solving
- Task prioritization
- Organization
- Verbal communication
Timeline
Overpayment Specialist
End-Game Strategy
07.2004 - Current
Claims Analyst
Cigna Healthcare
08.2000 - 07.2004
Bank Teller
Webster Bank
04.1999 - 08.2000
High School Diploma - general studies
Bristol Eastern High School