Carolyn Markov
Lombard,IL
Summary
Proven Claims Process Business Analyst with a track record of optimizing claims processing efficiency at Optum. Demonstrated ability to reduce resolution times and exceed productivity targets by leveraging problem-solving abilities and medical terminology knowledge. Excels in customer service and adapts swiftly to new technologies, ensuring compliance and high-quality standards.
Overview
42
42
years of professional experience
Work History
Claims Process Business Analyst
Optum
01.2012 - Current
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Managed workload and priorities to meet claims processing meet deadlines.
- Collaborated with cross-functional teams to resolve complex claims issues efficiently and effectively.
- Optimized the use of electronic claims submission systems to expedite claim processing times.
- Submitted electronic/paper claims documentation for timely filing.
Senior Claims Examiner
Principal Financial Group
03.1982 - 06.2011
- Reduced claim resolution time by conducting thorough investigations and timely decision making.
- Contributed to company growth by consistently meeting or exceeding productivity targets without sacrificing quality standards.
- Communicated with customers on claim decisions, status and all aspects of the claim process.
- Participated in special projects on claim issues, system and procedures that resulted in the business unit meeting timing goals.
- Followed compliance and timing guidelines to meet state and federal requirements.
Education
Business Administration
Shawnee Community College
Ullin, ILSkills
- Claims Processing Proficiency
- Problem-solving abilities
- Medical terminology knowledge
- Detail oriented
- Works well independently
- Excellent customer service skills
- Adapts quickly to new technologies, processes and procedures
- Ability to multi-task
Timeline
Claims Process Business Analyst
Optum
01.2012 - Current
Senior Claims Examiner
Principal Financial Group
03.1982 - 06.2011
Business Administration
Shawnee Community College
Similar Profiles
Samantha MyersSamantha Myers
Insurance Agent at OptumInsurance Agent at Optum
Summer PalmerSummer Palmer
Manager of Clinical Operations at OptumManager of Clinical Operations at Optum
Mo’neke WaltonMo’neke Walton
Sr. Install Admin at OptumSr. Install Admin at Optum
Umayma KhanUmayma Khan
Associate Data Scientist at OptumAssociate Data Scientist at Optum
Joshua PachecoJoshua Pacheco
Sales Representative at T-MobileSales Representative at T-Mobile