Celina Aiton
Litchfield Park,AZ
Summary
Proven in enhancing operational efficiency and customer satisfaction at United Health Group - Optum Health, Leverage expertise in support ticketing systems and exceptional teamwork to drive results. Analytical approach and collaborative spirit have consistently improved process outcomes, achieving significant gains in service delivery and issue resolution. Versatile Support Specialist skilled handling data, technical issues and personnel support tasks in distributed environment. Self-motivated and attentive with good interpersonal and problem-solving abilities. Offering 24 years of experience in the Healthcare field.
Overview
24
24
years of professional experience
Work History
Assoc Tech Support Analyst
United Health Group - Optum Health
11.2014 - Current
- Improved customer satisfaction by promptly addressing and resolving support issues, with a 98% resolution with in the frame.
- Streamlined support processes for increased efficiency and faster issue resolution.
- Created user accounts and managed access control.
- Collaborated with cross-functional teams to implement solutions that enhanced system performance.
- Conducted thorough analysis of user requirements, delivering tailored solutions to meet client needs.
- Implemented process improvements that resulted in reduced ticket resolution times and increased first-call resolution.
- Monitored helpdesk and responded to incoming tickets to address support needs.
- Developed comprehensive documentation to facilitate knowledge sharing among team members.
- Tested new software and hardware prior to deployment.
- Created user accounts and assigned permissions.
- Utilized ticketing system to track customer requests and prioritize urgent needs.
Supervisor of Operations
United Health Group - Optum Health
Phoenix , Arizona
04.2013 - 11.2014
- Evaluated staff of 9 peoples performance regularly, offering constructive feedback designed to promote growth within their roles.
- Managed scheduling and workload distribution, maximizing productivity without overwhelming team members or compromising quality of work.
- Achieved high levels of customer satisfaction with consistent attention to detail and effective communication skills.
- Established clear expectations for team members, fostering a positive work environment through open communication and accountability.
- Enhanced operational efficiency by streamlining processes and implementing best practices in the workplace.
- Adapted quickly to changing business needs, ensuring the operations team was always prepared for any shifts in demand or industry trends.
- Resolved conflicts between employees swiftly and professionally, maintaining a harmonious workplace atmosphere conducive to collaboration.
Claims Specialist
Dignity Health
11.2008 - 03.2013
- Worked on approximately 60 accounts a day, short payments, over payments, contract issues, till resolution.
- Reduced errors in claims submissions through meticulous attention to detail and thorough review processes.
- Improved claim processing efficiency by streamlining workflows and implementing best practices.
- Managed high volume of claims, consistently meeting deadlines without compromising accuracy or quality.
- Assisted in the development of policies and procedures related to medical claims management, ensuring compliance with industry regulations.
- Achieved timely reimbursements for clients through keen understanding of insurance company protocols.
- Contributed to the overall financial stability of the healthcare facility by consistently meeting or exceeding billing and collection targets.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Researched and resolved complex medical claims issues to support timely processing.
- Monitored and updated claims status in claims processing system.
- Managed large volume of medical claims on daily basis.
- Assessed medical claims for compliance with regulations and corrected discrepancies.
- Responded to correspondence from insurance companies.
- Followed up on denied claims to verify timely patient payment and resolution.
- Identified and resolved discrepancies between patient information and claims data.
- Processed insurance payments and maintained accurate documentation of payments.
- Checked documentation for accuracy and validity on updated systems.
- Generated, posted and attached information to claim files.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Coordinated with contracting department to resolve payer issues.
Senior Medical Claims Representative
Banner Health
09.2000 - 11.2008
- Handled complex claim issues, effectively communicating with patients and insurance companies to ensure payment resolution.
- Assisted in training new Medical Claims Representatives, sharing best practices for efficient claim processing.
- Supported departmental goals by working closely with team members to maintain consistent quality standards to have claims processed correctly.
- Contributed to overall department success through regular participation in meetings, sharing ideas for improvement initiatives.
- Improved patient satisfaction by efficiently processing medical claims and addressing inquiries.
- Appealed claims with all insurance companies to have claims paid correctly.
- Processed refunds on hospital claims that were over paid by the insurance companies.
- Met productivity goals of 45 accounts a day.
Education
High School Diploma -
Cental High School
Phoenix, AZ05-1997
Skills
- Support ticketing systems
- Application support
- Incident Management
- Support Services
- Technical solution analysis
- Teamwork and Collaboration
- User Support
- Analytical and Methodical
- Collaborative Team Player
Timeline
Assoc Tech Support Analyst
United Health Group - Optum Health
11.2014 - Current
Supervisor of Operations
United Health Group - Optum Health
04.2013 - 11.2014
Claims Specialist
Dignity Health
11.2008 - 03.2013
Senior Medical Claims Representative
Banner Health
09.2000 - 11.2008
High School Diploma -
Cental High School
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