Colleen Ann Rowe Kenyon
Buhl,USA
Summary
Detail-oriented business analyst with several years of experience conducting analysis and research to come up with solutions to common business problems. Polished in formulating business improvement strategies and overseeing new technology and system implementation. Commercially-aware professional with in-depth knowledge of computing systems and project management techniques.
Overview
1
1
Certification
23
23
years of professional experience
Work History
Operational Performance Business Analyst
Blue Cross Blue Shield of MN
2024.10 - 2026.08
- Conducted operational audits, securing management responses to address audit findings.
- Conducts audits of a variety of claims, phone calls and written forms of communication for accuracy based on auditing standards.
- Completed transactional audits per audit policies and procedures, ensuring compliance and accuracy.
- Enters timely and accurate documentation of audit findings into audit tracking systems per departmental policies and procedures.
- Resolved disputes of audit findings in collaboration with leadership across multiple divisions of Blue Cross.
Technical Specialist Claims
Blue Cross Blue Shield of MN
Virginia, USA
2015.08 - 2024.10
- Delivers training to Claims staff regarding claims adjudication, adjustments, and benefits.
- Assisted Claims Processors in adjudicating claims and resolving complex inquiries, enhancing overall claims processing efficiency.
- Delivered written and verbal feedback to Supervisors on employee performance to support improvement efforts.
- Assists Service Personnel with urgent requests, benefit inquiries and special projects as requested.
- Assisted Claims Processors in adjudicating claims, resolving complex inquiries, and troubleshooting claims issues.
- Assists Service Technical Specialist and MEAs with benefits and claims processing outcomes.
- Assists Operations Training Department in the development of training content, lesson plans, job aids and training materials.
- Responsible for assisting Claims staff while assisting in the resolution of difficult issues.
- Provides supplemental on-the-job training to new and existing Claims Processors in an individual or group setting.
Claims Examiner III
Blue Cross Blue Shield of MN
Virginia, USA
2003.12 - 2015.08
- Reviewed claims for accuracy and completeness to facilitate processing.
- Researched and resolved advanced system edits to ensure compliance and accuracy.
- Research and resolve advanced system edits.
- Review the claim to ensure proper information is on the claim to complete processing.
- Identified contract-specific situations and manually calculated benefits to ensure correct pricing and out-of-pocket procedures.
- Identify contract specific situations and manually calculate contract benefits using pricing and out-of-pocket procedures.
- Research and respond to inquiries via phone or in writing.
- Provided mentoring support to Examiner I and II staff upon request, enhancing their skills and knowledge.
Education
Bachelor of Arts - Political Science
Moorhead State University
Moorhead, MNAssociate of Arts - Liberal Arts
Hibbing Community College
Hibbing, MNSkills
- Claims adjudication
- Audit compliance
- Data analysis
- Excel
- Access
- Microsoft Teams
- Outlook
- Microsoft Word
Certification
- ARM, Associate in Risk Management, 07/01/02, AICPCU
- Intro to Risk Management, 09/01/00, AICPCU
Timeline
Operational Performance Business Analyst
Blue Cross Blue Shield of MN
2024.10 - 2026.08
Technical Specialist Claims
Blue Cross Blue Shield of MN
2015.08 - 2024.10
Claims Examiner III
Blue Cross Blue Shield of MN
2003.12 - 2015.08
Bachelor of Arts - Political Science
Moorhead State University
Associate of Arts - Liberal Arts
Hibbing Community College