Summary
Overview
Work History
Education
Skills
Timeline
Generic

Alexia Cook

Shadyside

Summary

Dynamic Insurance Claim Specialist with a proven track record at WVU Reynolds Memorial Hospital, excelling in claims investigation and patient service. Enhanced patient satisfaction through effective communication and timely resolutions, while maintaining meticulous documentation and compliance. Recognized for fostering teamwork and collaboration, driving efficient claims processing, and achieving significant improvements in turnaround times.

Insurance professional with comprehensive experience in claims management, adept at assessing, processing, and resolving claims efficiently. Proven skills in investigation, analysis, and negotiation, ensuring fair outcomes and policy compliance. Strong focus on team collaboration and adaptability, delivering results through effective communication and problem-solving. Reliable and flexible, meeting changing needs and maintaining high standards in all tasks.

Overview

15
15
years of professional experience

Work History

Insurance Claim Specialist

WVU Reynolds Memorial Hospital
08.2020 - Current
  • Strengthened patient relationships by providing clear communication throughout the claims process, ensuring all parties were well-informed of progress and outcomes.
  • Enhanced patient satisfaction by efficiently managing claims processes and providing timely resolutions.
  • Evaluated and settled complex insurance claims in strict timeframes.
  • Expedited claim resolutions through effective negotiation with patients,insurance companies, and pharmacies involved in the process.
  • Followed up with patients on denials and ensuring them to work my hardest to get them approved.
  • Expedited claim resolutions by adopting proactive approach to gathering necessary documentation and evidence.
  • Enhanced team productivity by getting the claims done in a timely manner and better turn around time for the patients .
  • Maintained up-to-date knowledge of regulatory changes, ensuring compliance in all claim handling procedures, as insurance policies are constantly changing.
  • Improved authorization processing efficiency by meticulously reviewing and validating each authorization for accuracy and completeness.

Managing Director

A&Company
04.2017 - 08.2020
  • Oversaw operations and provided corrective feedback to achieve daily and long-term goals.
  • Strengthened client relationships with regular communication, timely project delivery, and high-quality services.
  • Developed comprehensive business plans, outlining long-term goals and actionable steps toward success.
  • Oversaw complex negotiations with suppliers/vendors for favorable contract terms that led to cost savings.
  • Delivered consistent revenue growth by identifying new business opportunities and expanding service offerings.
  • Cultivated a strong organizational culture built on integrity accountability teamwork which resulted in higher retention rates among staff.
  • Enhanced customer satisfaction and loyalty by developing and implementing comprehensive customer service excellence program.

Administrative Assistant

Dr. Patrick Macedonia
01.2015 - 04.2017
  • Answered multi-line phone system, routing calls, delivering messages to staff and greeting patients.
  • Maintained confidentiality of sensitive information by adhering to strict privacy policies and implementing secure filing systems.
  • Delivered excellent customer service through prompt responses to patient inquiries, addressing concerns effectively, and building strong relationships.
  • Coordinated office supply inventory management, proactively ordering necessary items before depletion to avoid workflow disruptions.
  • Improved document organization with thorough file maintenance, archiving outdated records as necessary for efficient retrieval when needed.
  • Promoted a positive work environment through effective communication skills and fostering professional relationships among colleagues.
  • Collaborated on special projects as assigned by leadership, contributing research findings or coordinating event logistics as needed for success.
  • Maintained inventory of office supplies and placed orders.
  • Boosted team productivity by managing communication channels and ensuring timely responses to inquiries.
  • Monitored office supplies inventory, ensuring availability of essential items without overstocking.
  • Ensured accurate record-keeping with diligent data entry and database management for vital company information.

Administrative Executive

Dr. Jeremy Edgmon
01.2011 - 12.2014
  • Handled confidential information with utmost discretion, ensuring sensitive data was protected from unauthorized access.
  • Collected data, input records, and protected electronic files.
  • Improved patient satisfaction by promptly addressing inquiries and resolving issues in a timely manner.
  • Oversaw inventory management, maintaining optimal supply levels while minimizing waste and unnecessary expenses.
  • Maintained protocol throughout routine work days and special events.
  • Scheduled appointments and meetings, organized materials and prepared rooms.
  • Managed special projects as assigned; delivered results within established deadlines while meeting objectives.
  • Enhanced employee productivity by developing comprehensive training programs tailored to individual needs.
  • Implemented document management system that streamlined filing processes and facilitated easy retrieval of information.
  • Streamlined office procedures by implementing efficient systems and tools, resulting in improved workflow.
  • Optimized office space utilization through strategic rearrangement of furniture and equipment; created comfortable and functional work environments.
  • Enhanced office efficiency by streamlining file management processes, resulting in more organized digital archive system.
  • Improved data accuracy in internal databases by overseeing meticulous data entry and verification project.
  • Improved employee satisfaction by redesigning onboarding process, making it more engaging and informative for new hires.
  • Updated reports, managed accounts, and generated reports for company database.
  • Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving.
  • Trained employees in company and regulatory compliance requirements to promote conformance.
  • Collaborated with cross-functional teams to achieve organizational goals, fostering a positive work environment.

Education

Accounting And Finance

Northern Community College
Wheeling, WV

Managing Cosmetologist

Scott College of Cosmetology
Wheeling, WV

High School Diploma -

Bishop Donahue High School
McMechen, WV

Skills

  • Claims investigation
  • Claims analysis
  • Policy interpretation
  • Teamwork and collaboration
  • Attention to detail
  • Customer service
  • Active listening
  • Claims processing
  • Data entry
  • Insurance coverage verification
  • Documentation skills
  • Recordkeeping organization
  • Organizing and prioritizing work

Timeline

Insurance Claim Specialist

WVU Reynolds Memorial Hospital
08.2020 - Current

Managing Director

A&Company
04.2017 - 08.2020

Administrative Assistant

Dr. Patrick Macedonia
01.2015 - 04.2017

Administrative Executive

Dr. Jeremy Edgmon
01.2011 - 12.2014

Accounting And Finance

Northern Community College

Managing Cosmetologist

Scott College of Cosmetology

High School Diploma -

Bishop Donahue High School

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