Cynthia Mann
Columbus,OH
Summary
Results-oriented Claims Analyst bringing a wealth of experience, exceptional leadership and communication skills. Proven achiever with extensive experience in claims processing and case management. Teamwork oriented with excellent organizational skills and a customer service focus. Skilled in MS Office 365, AbsenceSoft, WorkDay, Prognos, PeopleSoft, and Kronos. Eager for an opportunity to acquire new skills and knowledge.
Overview
31
31
years of professional experience
Work History
Disability Claims Analyst
OhioHealth Corporation
09.2007 - Current
- Handle escalated cases professionally by resolving issues collaboratively with our legal team, HR Business Partners, case management, department management, healthcare providers and TPA.
- Respond to telephone, email and written inquiries from associates, physicians, medical staff, legal team, HR staff.
- Optimized customer satisfaction through prompt, empathetic, and professional communication during the claims process.
- Apply company policy, state & federal laws/requirements concerning leave of absence, FMLA, Worker's Compensation and company pay benefits,
- Process high volume of cases in a fast paced environment by prioritizing tasks and practicing strong organization skills,
- Collaborate with medical professionals as needed to ensure appropriate and necessary documentation is in place to support claims and/or Temporary Disability pay benefits.
- Train new Disability Claims Analysts on company policies, procedures, and best practices to ensure consistent quality service.
- Manage complex caseloads, demonstrating exceptional attention to detail for accuracy & meeting strict deadlines for notification under Federal law and company policy/procedure.
- Develop trusting relationships with colleagues, associates, management teams, legal team, HR staff and healthcare providers.
- Advise management on potential improvements to existing policies, contributing to the continuous refinement of company procedures and associate outcomes.
- Identify issues with Leave Management software providing insights for potential improvements in overall service delivery.
- Identify fraudulent medical documentation and work with colleagues, HR Business Partners and legal team on appropriate resolution.
- Maintain compliance with industry regulations by staying current on policy updates and implementing necessary changes.
- Assist colleagues in problem-solving challenging cases through collaboration and sharing of expertise in Disability Claims Management.
- Assist company supervisors with proper implementation of FMLA at department level and with understanding policy to help prevent discrimination or retaliation.
- Ensure associates are aware of their responsibilities regarding leave of absence and FMLA guidelines,
- Safeguard sensitive client information by following strict confidentiality guidelines and data security measures at all times during the claims process.
- Work with Excel spreadsheets to manage and track Worker's Compensation pay and Case Manager assignments.
- Review questionable claims by conducting reviews with Disability team and claimant interviews to correct omissions and errors.
- Administration of Temporary Disability pay, Supplemental Sick pay, Parental Leave pay and Time Away pay with working knowledge of Kronos time keeping system. Coordinate with Payroll department regarding code changes and payroll corrections.
- Determination and Administration of FMLA based on federal regulations.
- Worker's Compensation administration review, processing WC documents and recording OSHA reportable information.
- Provide wage reports for TPA and correspond with TPA regarding claim information.
- Provide correspondence via typed letters/forms as requested by department personnel and associates.
- Proficiency with Microsoft Office for clerical duties and communications.
- Utilize strong communication skills including active listening, validation, verification, cross checking, asking clarifying questions, connection/acknowledgement,
Shift Manager
Panera
07.2015 - 08.2017
- Trained new employees on policies/procedures and job responsibilities, ensuring seamless integration into the team.
- Improved overall team performance by effectively delegating tasks and providing clear instructions.
- Promoted a positive work environment through open communication and constructive feedback.
- Kept employees operating productively and working on task to meet business and customer needs.
- Developed strong relationships with neighborhood businesses, local law enforcement, customers, employees and their families.
- Worked closely with team members to schedule breaks and shifts to meet state regulations.
- Excelled in every store position and regularly backed up front-line staff.
- Collaborated with other managers to maintain consistency in policy enforcement across all shifts, fostering a cohesive workplace culture.
- Exercised composure under pressure and in escalated customer service scenarios.
- Ensured strict adherence to safety guidelines, reducing potential for accidents.
- Monitored inventory levels, maintaining optimal stock while minimizing waste and costs.
- Handled emergency situations with a calm demeanor, ensuring the safety of both customers and employees.
- Conducted regular evaluations of employee performance, identifying areas for improvement and offering targeted guidance for skill development.
- Monitored and analyzed sales data to identify trends and adjust strategies accordingly, staying ahead of market demands.
Unit Information Specialist
OhioHealth Riverside Methodist Hospital
03.2004 - 09.2007
- Organized, maintained and updated information in computer databases.
- Assisted internal staff with clerical and administrative needs to maximize efficiency and team productivity.
- Monitored and screened visitors to verify accessibility to inter-office personnel.
- Enhanced office organization by maintaining up-to-date medical records, both physical and electronic.
- Ensured compliance with HIPAA regulations by strictly adhering to privacy protocols when handling sensitive patient information.
- Collaborated with staff members on projects designed to enhance the overall function of the medical office environment.
- Adhered to strict HIPAA guidelines to protect patient privacy.
- Provided prompt, polite and professional in-person and telephone customer service.
- Collected and tracked patient medical information for use by healthcare providers on staff in EICU.
- Answered unit calls and took messages for healthcare staff to maximize team productivity.
- Processed physician orders for treatment, medications, labs and procedures and forwarded to appropriate departments.
- Communicated with healthcare staff in critical care areas from a remote location regarding orders from physician in the Electronic ICU.
- Documented updates to patient information in medical charts while maintaining HIPAA compliance protecting confidentiality of records.
- Consistently met deadlines when completing tasks such as filing documents or inputting data into the hospital''s system.
- Expedited communication between healthcare professionals, resulting in better coordination of care for patients.
- Collaborated with multidisciplinary teams to ensure optimal patient care and outcomes.
- Coordinated diagnostic tests, collection of samples and transportation to scanning rooms.
- Performed various administrative tasks by filing, copying and faxing documents.
Patient Care Technician
OhioHealth Riverside Methodist Hospital
01.1994 - 03.2004
- Monitored vital signs and reported changes to nursing staff, ensuring timely medical interventions when necessary.
- Assisted nurses with essential tasks, streamlining workflow and increasing efficiency in the healthcare setting.
- Enhanced patient satisfaction by providing compassionate and attentive care.
- Assisted in training new Patient Care Technicians, sharing knowledge and best practices to ensure consistency in care delivery.
- Performed blood draws, EKGs, and other diagnostic tests accurately and efficiently for prompt analysis by healthcare professionals.
- Contributed to a positive patient experience by keeping rooms clean, organized, and well-stocked with supplies.
- Fostered strong relationships with colleagues, contributing to a collaborative work environment that prioritized teamwork among staff members.
- Assisted in transferring patients, beds and patient care equipment to other rooms adhering to necessary safety precautions.
- Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
- Recognized potential emergencies promptly, initiating appropriate action to stabilize patients until further assistance arrived.
- Reduced stress for patients and families through effective communication and empathetic support.
- Demonstrated adaptability by working effectively with patients of diverse backgrounds and medical conditions, providing personalized care for each individual.
- Participated in ongoing professional development opportunities to stay current on best practices in patient care technology advancements.
- Supported optimal wound healing by skillfully changing dressings and monitoring for signs of infection or complications.
- Educated patients on self-care techniques and post-discharge instructions, empowering them to take control of their own health maintenance.
- Delivered compassionate end-of-life care, offering comfort and dignity to patients in their final stages.
- Collected and documented patient information to aid in accurate medical record keeping.
- Assisted nursing staff with medical procedures to support patient care plans.
- Monitored patient specimen samples and test results to effectively alert supervisors of potentially unhealthy changes.
Education
Nursing Pre-requisite Studies
Columbus State Community College
Columbus, OHSkills
Customer service focus
Critical thinking abilities
Professionalism and Integrity
Teamwork orientation
Medical terminology
Organizational Skills
Adaptability and Flexibility
Workload prioritization
Claims Processin
MS Office 365
Case Management
Payment Processing
Accomplishments
Nominated for position of Diversity Liaison for 2 year term at OhioHealth.
Received Compassion Award during Prism Award Event at OhioHealth -twice nominated
Helped successfully initiate processes for the Electronic ICU at Riverside Methodist Hospital
Timeline
Shift Manager
Panera
07.2015 - 08.2017
Disability Claims Analyst
OhioHealth Corporation
09.2007 - Current
Unit Information Specialist
OhioHealth Riverside Methodist Hospital
03.2004 - 09.2007
Patient Care Technician
OhioHealth Riverside Methodist Hospital
01.1994 - 03.2004
Nursing Pre-requisite Studies
Columbus State Community College
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