Christine Arthur
Summary
Dedicated Claims Specialist focused on driving operational efficiency and ensuring regulatory compliance in claims processing. Delivered positive claimant experiences through effective communication and conflict resolution skills. Provided training and support as Assist Skill Coach, enhancing team performance and promoting accuracy and compliance.
Overview
19
19
years of professional experience
Work History
Absence Manager
New York Life
01.2022 - Current
- Executed claim determinations, ensuring accurate processing to support claimant satisfaction.
- Managed ongoing claims, adhering to standard timeframes to enhance operational efficiency.
- Processed all covered claims accurately and on time.
- Verified customer eligibility for claims efficiently.
- Communicated with claimants, employers, and medical professionals to gather necessary information.
- Resolved overpayment issues with claimants, fostering transparency and trust in the claims process.
- Supported fellow claim departments in resolving complex issues.
- Responded to telephonic and email inquiries promptly, following customer service protocols.
Assistant Skill Coach (temporary assignment)
New York Life
09.2024 - 10.2025
- Coached new hires through personalized one-on-one sessions to enhance onboarding experience.
- Monitored trainee progress during on-the-job training, offering targeted feedback.
- Delivered performance assessments to team leaders regarding new hires' OJT progress.
- Audited claim reviews and emails, delivering constructive feedback to support new hires' development.
- Verified accuracy of policy information and plan documents to ensure compliance and clarity.
- Communicated NYL policies, ensuring comprehensive training on regulations.
- Supported claim performance management by reviewing quality and compliance standards.
- Guided core teams by addressing inquiries and managing escalation calls.
Unit Secretary
St Clair Hospital
Mt Lebanon, PA
04.2020 - 01.2021
- Answered and delegated telephone calls to appropriate staff, ensuring efficient workflows.
- Prepared discharge packets for nursing home patients with high efficiency.
- Released written orders promptly and accurately.
- Faxed orders to nursing homes, ensuring timely delivery.
- Coordinated and scheduled training classes for hip and knee replacement surgeries to enhance staff preparedness.
- Trained new employees in unit secretary role, promoting operational readiness.
- Communicated hospital policy updates effectively to unit personnel.
- Developed documents using Microsoft Word and Excel to streamline departmental operations.
Customer Service Advocate / Account Champion
Cigna
Robinson, PA
05.2018 - 10.2019
- Clarified claims processes and requirements, enhancing customer understanding and satisfaction.
- Verify eligibility for services efficiently to expedite access.
- Obtain and deliver pre-service estimates to enhance decision-making.
- Assist customers in locating in-network providers effectively.
- Explained benefits to customers, ensuring comprehensive understanding and informed decision-making.
- Assessed and prioritized issues before escalating to account manager.
- Outreached to health care providers, facilitating resolutions for pending or denied claims.
- Identify and submit claims requiring reprocessing to minimize delays.
Medical Image Scheduler
St Clair Hospital
Mt Lebanon, PA
03.2015 - 05.2018
- Managed scheduling of medical imaging tests to optimize interdepartmental workflows.
- Coordinated scheduling for PET-CT procedures across multiple imaging departments to enhance service delivery.
- Verified insurance and authorizations to streamline patient access to imaging services.
- Conducted outreach to health care providers and insurance carriers for authorization support.
- Communicated with patients regarding authorization statuses to enhance understanding.
- Trained and evaluated new medical image schedulers for role readiness.
- Showcased knowledge of medical imaging tests and their related questionnaires.
- Served as beta tester for new appointment system, identifying potential improvements.
Support Assistant
Citizen Care Inc
McKees Rocks, PA
12.2014 - 03.2015
- Developed independent living skills programs for individuals with intellectual disabilities, enhancing daily functioning.
- Ensured compliance with daily activity schedules to support routine stability.
- Coordinated transportation for budgeting and medical appointments, ensuring access to essential services.
- Administered medication while adhering to safety protocols.
- Delivered personal care assistance, including bathing and hygiene support, to maintain dignity and well-being.
Caregiver
Home Instead Sr. Care
Mt Lebanon, PA
04.2014 - 06.2014
- Supported clients with daily living activities and personal care to enhance their quality of life.
- Provided companionship and emotional support to enhance client well-being.
- Administered medications and monitored health conditions.
- Coordinated meals, medication reminders, and transportation to ensure comprehensive personal care.
Personal Caregiver
Helene Berman
Squirrel Hill, PA
02.2014 - 03.2014
- Assisted clients with daily living activities and personal hygiene tasks.
- Supported individuals in daily living activities and personal care to promote independence and improve quality of life.
- Provided companionship and emotional support to enhance client well-being.
- Managed medication schedules and ensured proper administration for clients.
Supports Assistant, Senior Support Assistant
Citizen Care Inc.
McKees Rocks, PA
02.2007 - 02.2014
- Facilitated completion of daily activity schedules for clients.
- Facilitated independent living skills training to empower clients and promote autonomy.
- Coordinated transportation budgets, banking activities, and medical appointment scheduling to ensure client access to necessary services.
- Provided assistance with personal care tasks, including bathing.
- Administered medication according to prescribed protocols.
- Evaluated initial and annual training for medication administration.
- Determined assignments and activities for staff based on client needs.
- Assisted manager by leading training sessions for support assistants to improve service delivery.
Resident Aide
Providence Point Nursing Home
Pittsburgh, PA
03.2012 - 06.2013
- Provided assistance with daily personal care tasks, including medication administration and meal service.
Supported individuals in maintaining hygiene, grooming, and mobility needs.
Monitored and recorded vital signs, escalating concerns as necessary.
Collaborated with caregivers to develop tailored care plans for each resident.
Ensured cleanliness of living areas to uphold health standards.
Engaged clients in meaningful activities to foster social interaction and enjoyment.
Documented daily observations to facilitate continuity of care.
Facilitated safe mobility and positioning during daily routines. - Assisted residents with daily tasks to promote independence and enhance overall well-being.
- Maintained orderly and sanitary living areas to ensure health and safety standards.
- Facilitated open communication with residents and families to effectively address needs and concerns.
Education
AS - General Stuides
Community College of Allegheny County
Pittsburgh, PA09.2020
Skills
- Employee training
- Coaching methods
- Motivational leadership
- Team development
- Conflict management
- Performance improvements
- Problem resolution
- Process improvement
- Policy compliance
- Compliance management
- Time management
- Customer communication
- Constructive feedback
References
Hannah Ketterman, (412) 722-3003, Jade Landon, (412) 680-4810, Jennifer Lasser, (412) 980-8991, Jessica Luntz, (907) 978-8668, Helene Berman, (412) 427-5730, Mara Hartman, (412) 946-8175
Timeline
Assistant Skill Coach (temporary assignment)
New York Life
09.2024 - 10.2025
Absence Manager
New York Life
01.2022 - Current
Unit Secretary
St Clair Hospital
04.2020 - 01.2021
Customer Service Advocate / Account Champion
Cigna
05.2018 - 10.2019
Medical Image Scheduler
St Clair Hospital
03.2015 - 05.2018
Support Assistant
Citizen Care Inc
12.2014 - 03.2015
Caregiver
Home Instead Sr. Care
04.2014 - 06.2014
Personal Caregiver
Helene Berman
02.2014 - 03.2014
Resident Aide
Providence Point Nursing Home
03.2012 - 06.2013
Supports Assistant, Senior Support Assistant
Citizen Care Inc.
02.2007 - 02.2014
AS - General Stuides
Community College of Allegheny County