Summary
Overview
Work History
Education
Skills
Timeline
Generic

DENISE STRAWDER-HENRY

MARGATE

Summary

Experienced claims analyst with a proven track record in evaluating, processing, and resolving insurance claims. Prioritizes team collaboration and adaptability for seamless operations and optimal outcomes. Demonstrates strong organizational skills and dependability to successfully manage multiple priorities with a positive attitude. Always willing to take on additional responsibilities to meet team goals. Expertise in data analysis, risk assessment, and customer service consistently delivers reliable and efficient results. Known for excellent problem-solving and critical thinking abilities, maintains high standards in all tasks in a high-volume insurance environment.

Overview

26
26
years of professional experience

Work History

Reservationist

American Airlines
07.2020 - Current
  • Utilized reservation software proficiently, ensuring quick response times during high call volumes.
  • Enhanced customer satisfaction by efficiently managing reservations and promptly addressing inquiries.
  • Handled challenging situations or dissatisfied customers professionally, resolving issues and retaining business when possible.
  • Proactively communicated potential availability issues or overbooking concerns with management to find solutions before impacting guest experience.
  • Consistently met or exceeded performance metrics for call handling, reservation accuracy and upselling.

CLAIMS ANALYST

Humana Health Care
01.2013 - 05.2020
  • Consistently met and exceeded quality and productivity standards, ensuring timely and accurate claims processing
  • Increased departmental accuracy by implementing quality control measures for claim submissions and reimbursements.
  • Ensured accurate payments by meticulously reviewing medical records, invoices, and supporting documentation.
  • Enhanced claim processing efficiency by implementing automated workflows and streamlining procedures.
  • Achieved successful resolutions on disputed claims through effective collaboration between internal departments such as legal counsel and clinical experts.
  • Maintained regulatory compliance by staying current with industry guidelines, state laws, and federal regulations.
  • Assisted in the development of standardized processes for claim adjudication across multiple insurance products.

CLAIMS EXAMINER III

HIP Administrators, Inc.
04.2000 - 01.2013


  • Applied advanced knowledge of Coordination of Benefits, contributing to seamless benefit calculations
  • Meticulously investigated and resolved discrepancies, minimizing errors and potential financial losses for the organization
  • Handled sensitive information with discretion, ensuring confidentiality of personal and financial details for claimants throughout the claims examination process.
  • Utilized analytical skills to evaluate medical bills for accuracy and appropriateness of charges before approving payments as part of the claims process.

CUSTOMER SERVICE ADVOCATE

HIP Administrators, Inc.
09.1998 - 04.2000
  • Resolved member inquiries efficiently, leveraging detailed knowledge of HIP policies and procedures
  • Communicated effectively with internal departments and external providers to ensure the resolution of complex issues
  • Promoted superior experience by addressing customer concerns, demonstrating empathy, and resolving problems swiftly.
  • Managed high call volume during peak hours, prioritizing urgent cases while maintaining attention to detail.
  • Maintained a positive work environment, fostering team collaboration and continuous improvement.
  • Helped large volume of customers every day with positive attitude and focus on customer satisfaction.

Education

BACHELORS - ORGANIZATIONAL LEADERSHIP, MINOR IN PHYSIOLOGY

Trinity International University
Bannockburn, IL
05.2024

Skills

  • Claims Analysis
  • Regulatory Compliance
  • Medical Terminology
  • Workflow Optimization
  • Customer Service
  • Account Management
  • HIPAA
  • FMLA
  • LOA
  • STD
  • ADA
  • Coordination of Benefits
  • Data Analysis
  • Customer reservations
  • Problem-solving aptitude
  • Sabre software
  • Reservation confirmation
  • Special needs assistance
  • Written communication
  • Client relations
  • Documentation
  • Verbal and written communication
  • Active listening
  • Creative thinking
  • Creative problem solving
  • Project Management
  • Interpersonal Skills
  • Analytical Thinking
  • Attention to Detail
  • Quality Assurance
  • Conflict Resolution
  • Problem Solving
  • Client Relations
  • Patience and tolerance
  • Verbal communication
  • Call center experience
  • Professionalism and courtesy
  • Claims analysis
  • Data verification
  • Reservation software
  • Disability claims process
  • Interpersonal and written communication
  • Investigative skills
  • Data interpretation
  • Complaint resolution
  • Telephone reservations
  • Document workflow
  • Claim investigation
  • Disability processing
  • Decision-making skills
  • Policy review

Timeline

Reservationist

American Airlines
07.2020 - Current

CLAIMS ANALYST

Humana Health Care
01.2013 - 05.2020

CLAIMS EXAMINER III

HIP Administrators, Inc.
04.2000 - 01.2013

CUSTOMER SERVICE ADVOCATE

HIP Administrators, Inc.
09.1998 - 04.2000

BACHELORS - ORGANIZATIONAL LEADERSHIP, MINOR IN PHYSIOLOGY

Trinity International University

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DENISE STRAWDER-HENRY