Cynthia Mitchell
Antioch,TN
Summary
An experienced motivated professional looking to obtain a new and challenging position that promotes leadership, individual security and longevity.
Overview
18
18
years of professional experience
Work History
Claims Account Manager
Caterpillar Financial Services Corporation
Nashville, Tennessee
04.2025 - Current
- Managing relationships with third party claims companies, insurance fronting companies, and reinsurance companies.
- Analyze large claims data sets to identify claims trends, issues, and recommendations.
- Understanding of multiple internal and external claims, and financial applications, to process required business.
- Researching the best practices, procedures and priorities for the settlement of claims, in the given product area.
- Performing the oversight of claims in the given product area consistent with policy terms, legal and regulatory issues, corporate financial goals and customer needs
Customer Accounts Specialist II
Caterpillar Financial Services Corporation
Nashville, Tennessee
05.2023 - Current
- Knowledge of customer service concepts and techniques with the ability to exceed customer needs and expectations.
- Provides excellent service in a direct or indirect manner.
- Responds to unexpected customer requests and needs with a sense of urgency and positive action.
- Uses effective communication to transmit, accurately interpret ideas and information through delegation.
- Ability to complete tasks with high levels of precision, accuracy, and attention to detail.
- Team player that utilizes feedback to regulate workflow processes efficiently and effectively.
- Clarifies immediate demands and balances them with important long term and/or high priority issues.
Account Receivables Analyst
Nissan Trading Corporation
Smyrna, TN
04.2022 - Current
- Management of trade accounts receivable, including customer contact to determine reasons for non-payment, internal reporting of account issues and maintain accurate records in NetSuite accounting system including customer activity and interaction and payment application.
- Gives team support as backup for Credit and Cash Analyst.
- Analyze, research and investigate accounts receivable reports as needed while maintaining accuracy of all billing and invoicing.
- Support month-end closing procedures as assigned, including internal reports and intercompany balancing.
- Special projects and other duties as assigned by management.
- Assist Sales Department with Accounting needs.
Corporate Business Office Claims Coordinator
Results Physiotherapy
Nashville, TN
06.2021 - 02.2022
- Managed paper claims.
- Open, sorted, date stamped and scanned incoming mail to the appropriate departments.
- Scanned claims billing requests for submission.
- Match medical records and/or Explanation of Benefits for both paper and electronic claims for primary and secondary claims.
- Scanned payment posting batches to the Shared Drive.
- Scanned Central Billing Office monthly correspondence batches.
- Ran postage machine in preparation for outgoing claims in bulk for USPS pick-up.
Accounts Receivable Specialist
Steward Healthcare
Franklin, Tennessee
06.2018 - 01.2021
- Handled denials to appeal with effective results in decision being overturned and paid.
- Methodically resolved active claims by analyzing possible discount violations, shortages, returns and overpayments.
- Timely follow-up with carriers regarding payment issues on delinquent accounts.
- Responsible for various aspects of medical billing including workers compensation, claim submission, payment posting for insurance and patient balances.
- AthenaNet system experience.
- Obtained supporting documentation; i.e, medical records, EOB's, remits, authorizations, and referrals.
Account Reimbursement Specialist
Vanderbilt University Medical Center
Nashville, Tennessee
12.2017 - 06.2018
- Meets productivity standards specific to the work unit guidelines.
- Analyze incoming financial data to identify patterns from insurance carriers and/or entities resulting in erroneous or no reimbursement.
- Accesses and protects incoming financial data.
- Serves as liaison with insurance companies, third party payers, and administrative personnel including Contracts Administration and customers.
Compliance Auditor
Cigna-Healthspring
Nashville, Tennessee
10.2017 - 12.2017
- Audited calls during Medicare enrollment period to ensure that Medicare guidelines were being followed by the sales agents.
- Audited each call and gave quality feedback for the use of continued learning and development of the sales agents.
- Ensured that sales agents were in compliance within the laws, regulations, policies and procedures of the company and Medicare.
- Researched effectively before reaching a conclusion that compliance was followed or did not meet the standards.
- Worked in the multiple systems for the audit of each call to make sure that aggressive or fraudulent sales practices were not being used.
Interim Workers Compensation Coordinator
Logan's Roadhouse
Nashville, Tennessee
07.2017 - 09.2017
- Served as the main contact for the company's workers compensation claims coordinator in the risk management department for all 192 restaurants during that time-frame.
- Received and responded to all workers compensation claims. Contacted claimants, general managers and assistant managers in the gathering of all pertinent data and information regarding the injury that took place.
- Obtained witness interviews and documentation of initial investigations of the injury report.
- Reported the claims to the third party administrator and assisted seeing investigations to their conclusion.
- Monitored claims to ensure timely investigation taken by the adjuster to completion.
- Managed the volume of claims received from all incoming worker accident reports from the restaurants.
- Tracked workers compensation claim trends.
- Met with adjusters in regards to claims that turned into workplace cases.
Insurance Representative/Extended Business Office
Community Health Systems
Brentwood, TN
10.2011 - 11.2016
- Build viable relationships with facility contacts with an open line of communication to resolve billing issues.
- Verify with the workers compensation insurance carrier that the claim is on file and status of processing.
- Appeal denials received to obtain a successful overturned decision with payment to follow.
- Negotiate settlements with attorneys and/or adjusters' on accounts that are due to motor vehicle accident, workers compensation or personal injury.
- Verify attorney representation and that all related bills have been received and are on file.
Insurance Representative/Insurance Department
Community Health Systems
Brentwood, TN
04.2008 - 10.2011
- Verify insurance eligibility for patients who have received medical services at all CHS hospitals.
- Works meticulously to insure that all billing expectations have been met.
- Exemplify excellent customer service and people skills.
- Work effectively with commercial and government insurance companies regarding reasons for denial of payment.
Education
Bachelor of Science - Social Sciences
Tennessee State University
Nashville, TN05.2022
Skills
- Readily accepts challenges, meets and exceeds all business objectives
- Possess leadership qualities
- A solid team player that is goal and results driven
- People and customer service oriented
- Performs tasks to completion
- Resolves billing disputes
Affiliations
PASI Senior Society BronzeCertified Healthcare Collector, January 2012-presentLeadership Development Training Graduate, May-December 2010
Accomplishments
- Assist patients with financial arrangements on outstanding balances due
- Skip tracer. Instrumental in locating a person's whereabouts to make aware of balances owed for medical services rendered and obtaining payment on that outstanding amount
Skills
Claims, Billing, Cases, Compensation, File, Liability, Litigation, Settlements, Workers Compensation, Customer Service, Receptionist, Retail Sales, Arrangements, Collections, Credit, Medical Collections, Payments, Skip Tracer, Their Account, Commercial Insurance, Educating, Problem Solver, Customer Service Oriented, Goal-oriented, Healthcare, Leadership Development, Team Player, Training
Timeline
Claims Account Manager
Caterpillar Financial Services Corporation
04.2025 - Current
Customer Accounts Specialist II
Caterpillar Financial Services Corporation
05.2023 - Current
Account Receivables Analyst
Nissan Trading Corporation
04.2022 - Current
Corporate Business Office Claims Coordinator
Results Physiotherapy
06.2021 - 02.2022
Accounts Receivable Specialist
Steward Healthcare
06.2018 - 01.2021
Account Reimbursement Specialist
Vanderbilt University Medical Center
12.2017 - 06.2018
Compliance Auditor
Cigna-Healthspring
10.2017 - 12.2017
Interim Workers Compensation Coordinator
Logan's Roadhouse
07.2017 - 09.2017
Insurance Representative/Extended Business Office
Community Health Systems
10.2011 - 11.2016
Insurance Representative/Insurance Department
Community Health Systems
04.2008 - 10.2011
Bachelor of Science - Social Sciences
Tennessee State University