Elayne Warden
Marshall,Texas
Summary
Dedicated professional with strong analytical research skills and a proven track record of dedication and ethics. Focused on quality-driven service I am an effective and creative problem solver with a commitment to enhancing customer satisfaction through effective communication and support.
Overview
21
21
years of professional experience
Work History
Provider Services Representative
HCSC, Blue Cross Blue Shield of Texas
Marshall, Texas
02.2018 - Current
- Handle provider appeals and disputes through online platforms and traditional mail, guaranteeing prompt response times.
- Coordinate follow-up requests with providers, facilitating timely appeal processing.
- Promote high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Manage provider inquiries and resolve issues, enhancing service reliability.
- Educate providers on network participation, member eligibility and policy benefits.
- Develop relationships with providers by guiding them on system usage, inquiry submission, and accurate claims submission.
- Process and adjust provider submitted claims.
- Verify accuracy of submitted medical records and other documentation.
- Participate in beta/test groups to create and improve front line systems by communicating feedback and opinions on behalf of the provider services department.
- Conduct thorough research to enhance service delivery and support.
Membership and Marketing Team Lead
Sam's Club
Longview, Texas
01.2010 - 02.2018
- Trained and mentored team members on marketing and membership sales best practices, enhancing team capability.
- Coordinated events and promotions that engaged local communities and increased membership awareness.
- Scheduled and attended outside sales events. Exceeded company standards in membership sales.
- Developed relationships with external vendors to deliver innovative campaigns that aligned with marketing objectives.
- Created detailed project briefs for the marketing team and monitored progress on projects.
- Coordinated with internal teams to ensure alignment between departments.
- Assisted management in interviewing, training, scheduling and leading membership and marketing employees.
- Received Associate of the Year Award for exceptional performance.
Independent Landman
Self
Marshall, Texas
01.2005 - 01.2008
- Analyzed mineral deed chains, property records, court orders, probates and other related documents to determine ownership interests in oil and gas properties.
- Conducted research on land titles and ownership records to support due diligence in land acquisition.
- Maintained accurate records of land transactions and agreements to ensure compliance with legal requirements.
- Developed maps and visual aids to clearly communicate proposed project sites and boundaries to stakeholders.
- Reviewed completed work to verify consistency, quality, and conformance.
Education
Intermediate Certificate - Emergency Medical Technician
Marshall Fire And Paramedic
Texas11.2001
Certificate - Emergency Medical Technician
Marshall Fire And Paramedic
Texas04.2000
High School Diploma -
Marshall High School
Marshall, TX05.1999
Skills
- Claims processing
- Dispute resolution
- Document review
- Due diligence
- Quality customer service
- System navigation
- Analytical research skills
- Technical proficiency
- Problem solving
- Critical thinking
- Medical Terminology
Timeline
Provider Services Representative
HCSC, Blue Cross Blue Shield of Texas
02.2018 - Current
Membership and Marketing Team Lead
Sam's Club
01.2010 - 02.2018
Independent Landman
Self
01.2005 - 01.2008
Intermediate Certificate - Emergency Medical Technician
Marshall Fire And Paramedic
Certificate - Emergency Medical Technician
Marshall Fire And Paramedic
High School Diploma -
Marshall High School