Emani Taylor
Summary
Detail-oriented Analyst with a proven track record in claims management, eligibility verification, and data coordination. Skilled in identifying patterns, resolving discrepancies, and ensuring compliance with regulatory standards. Experienced in collaborating with cross-functional teams to manage high-volume tasks while safeguarding operational integrity. Proficient in database management, documentation, and risk mitigation, with a strong commitment to accuracy and efficiency
Overview
4
4
years of professional experience
Work History
Claims Benefit Coordinator
Symetra
04.2023 - Current
- Investigated and processed high-volume, complex insurance claims, ensuring accurate benefits allocation and adherence to policies.
- Identified patterns and discrepancies in claims data, escalating suspicious activities for further review
- Utilized advanced database management techniques to enhance efficiency in claims review and resolution.
- Provided detailed documentation of claims findings, contributing to team reports and operational improvements.
Eligibility Worker
Apex Systems
09.2023 - 09.2024
- Conducted detailed assessments of public assistance program applications to verify accuracy and compliance with regulations.
- Analyzed client information for eligibility criteria, identifying inconsistencies and potential fraudulent documentation.
- Streamlined the data migration process from outdated systems, ensuring integrity and accuracy.
Policy Administrator
Aston Carter
10.2022 - 04.2023
- Reviewed and coded insurance policy documents, identifying irregularities in submissions for corrective action.
- Maintained meticulous filing systems, ensuring compliance with organizational and regulatory standards.
- Collaborated with cross-functional teams to address anomalies in policy administration systems, ensuring operational integrity.
- Drafted and analyzed stop-loss contracts, enhancing risk management capabilities.
Claims Advocate
Blue Cross Blue Shield
05.2021 - 10.2022
- Calculated adjustments, deductibles, premiums and refunds
- Checked documentation for accuracy and validity on updated systems
- Managed a high volume of support tickets and chats, addressing customer inquiries with accuracy and professionalism
Customer Service Representative
Kelly Services
10.2020 - 05.2021
- Responded to 55-80 daily inquiries, providing timely and accurate solutions for customer concerns.
- Maintained detailed records of interactions, contributing to case documentation and resolution reports.
- Delivered forward-thinking strategies to improve customer satisfaction while maintaining adherence to policies.
Education
Associate of Arts -
Florence Darlington Technical College
Bachelor of Science - Health Informatics
University of South Carolina
Columbia, SC06-2026
Skills
- Microsoft Office / Excel
- Database management
- Time management
- Attention to detail
- Case Documentation
- Compliance with regulations and standards
LANGUAGES
English
Timeline
Eligibility Worker
Apex Systems
09.2023 - 09.2024
Claims Benefit Coordinator
Symetra
04.2023 - Current
Policy Administrator
Aston Carter
10.2022 - 04.2023
Claims Advocate
Blue Cross Blue Shield
05.2021 - 10.2022
Customer Service Representative
Kelly Services
10.2020 - 05.2021
Associate of Arts -
Florence Darlington Technical College
Bachelor of Science - Health Informatics
University of South Carolina
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