Carrie J Cooke
Bernhards Bay,NY
Overview
2
2
years of professional experience
Work History
Sr. Resolution Analyst
UnitedHealthcare
Kingston, NY
03.2023 - Current
- Responsible for providing expertise or general support to teams in reviewing, researching, investigating, negotiating, and resolving all types of appeals
- Analyze / research / understand how a claim was processed and why it was denied
- Obtain relevant medical records, needed to make an appropriate determination
- Determine where specific appeals should be handled, and route to other departments as appropriate
- Ensure that members/providers obtain a full and fair review of their appeal
- Make appropriate determinations about whether a claim should be approved or denied based on available analyses / research of claims information
- Document final determination of appeals, using appropriate templates, communication processes, etc. (e.g., response letters)
Disability Claims Specialist
Metlife
Oriskany, NY
05.2022 - 02.2023
- Complied with confidentiality regulations
- Answered and logged incoming inquiries via phone, fax and email.
- Performed intake, providing documents in both English and Spanish
- Thoroughly investigates and resolves customer concerns while maintaining highest standards of objectivity and integrity
Data Entry
AllSource Analysis
Glendale, CA
01.2022 - 05.2022
- Identified and corrected data entry errors to prevent duplication across system
- Updated clients company death benefits
Education
Associate of Applied Science - Information Technology
Bryant & Stratton
Buffalo, NY06.2019
Associate of Applied Science - Medical Administration
Bryant & Stratton
Buffalo NY06.2017
Skills
- Empire Specific
- UNET Platform
- ISet, COW, CADE
- Macro Champ
- Experience with creating Resolution Letters
- Microsoft Office
- Decision-making
- Research and analytical skills
Timeline
Sr. Resolution Analyst
UnitedHealthcare
03.2023 - Current
Disability Claims Specialist
Metlife
05.2022 - 02.2023
Data Entry
AllSource Analysis
01.2022 - 05.2022
Associate of Applied Science - Information Technology
Bryant & Stratton
Associate of Applied Science - Medical Administration
Bryant & Stratton
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