CHERYL WESTBROOK
Reynoldsburg,OH
Summary
30+ years in the medical/health insurance field, specializing in insurance claims processing/billing. Proficient with software Medical Manager, Lytec Billing and Health Axis. I am a hardworking and reliable employee who supports the team and has great customer service skills and works very well independently.
Overview
16
16
years of professional experience
Work History
Claims Supervisor
Gainwell Technologies
Dublin, OH
08.2022 - Current
- Supervises claims program administration to ensure proper claims practices and procedures
- Assists in implementing procedures to adjust claims when original demographic, sponsor or charge information is in error
- Assumes supervisory responsibility for electronic and paper claims submissions
- Oversees analysis, correction and resubmission of registration and eligibility of edits and errors
- Recommends and/or initiates the selection and hiring of employees
- Evaluates employees to enhance their performance, development, and work productivity.
- Addresses performance issues and makes recommendations for personnel actions
- Makes recommendations for salary increases
- Researches coding and reimbursement requirements for compliance with local, state and federal regulations
Senior Claims Analyst
Gainwell Technologies
Dublin
02.2022 - Current
- Reviews insurance claims received electronically or in written form
- Evaluates available information to validate claims
- Investigates simple to moderately complex claims and determines level or resolution if appropriate
- Identifies need for additional information and contacts appropriate source to obtain needed information
Senior Supervisor, Claims
Advisory Health Administrators
Lexington, KY
06.2021 - 02.2022
- Planned and published production schedule and directed staffing and resources to meet production goals
- Collected statistical data and documentation to report on production status
- Met and exceeded productivity with implementation of new processes to improve quality output
- Coordinated resources and schedules to meet targets and adhere to deadlines
Team Lead
United Healthcare
Columbus, OH
07.2019 - 06.2021
- Mentor team members on group plans, speed and efficiency to help improve team productivity
- Observe employees to identify deficiencies and implemented strategies to broaden knowledge
- Run reports and send out work to team members
- Control the inventory of team's clients
- Schedule/lead meetings
- Work with plan build to correct mistakes in client's benefits
- Take lead for supervisor when supervisor is out of the office
Senior Analyst
Healthscope Benefits (merged with UHC)
Columbus, OH
01.2014 - 06.2021
- Proper adjudication of medical claims
- Running/processing of reports
- Verify authorized services
- Verify correct ICD/CPT coding submitted by facilities/providers
- Entry of member payable claims
- Chosen to participate in several pilot programs to make sure they function correctly
Medicare/Medicaid Specialist
Aetna
Columbus, OH
01.2010 - 01.2014
- Proper adjudication of medical claims
- Verified authorized services
- Verified correct ICD/CPT coding on claims
Education
Bachelor of Arts - Sociology
Ashford University
Clinton, Iowa06.2011
Associate of Arts - Computer Applications
Technology Education College
Columbus, OH06.2002
Skills
- Decision making
- Team building
- Organized
- Critical thinking
- Mentoring
- Prioritization
- Time management
- Attendance
- Claims management expertise
- Policy interpretation
- Claims auditing
- Planning and organization
- Team motivation
- Claims analysis
- Claims processing
- MS office suite
- Performance monitoring
Timeline
Claims Supervisor
Gainwell Technologies
08.2022 - Current
Senior Claims Analyst
Gainwell Technologies
02.2022 - Current
Senior Supervisor, Claims
Advisory Health Administrators
06.2021 - 02.2022
Team Lead
United Healthcare
07.2019 - 06.2021
Senior Analyst
Healthscope Benefits (merged with UHC)
01.2014 - 06.2021
Medicare/Medicaid Specialist
Aetna
01.2010 - 01.2014
Associate of Arts - Computer Applications
Technology Education College
Bachelor of Arts - Sociology
Ashford University