Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Gina Trosky

Enon Valley,PA

Summary

Insurance professional with extensive experience in many aspects of the industry including Quality Supervision, Analytics, Claim Processing, Claim Adjustments, Auditing and Customer Service with an excellent reputation for resolving problems and improving customer satisfaction.

Overview

18
18
years of professional experience
1
1
Certification

Work History

QUALITY SUPERVISOR

UnitedHealthcare
06.2020 - Current
  • Oversaw department of 9 claims auditors for 4 separate audit programs (UNET Focus Audit, CCM SAM Edit Rule, Data Capture & CDH)
  • Supervised daily operations, providing support, and coordinating all personnel needs
  • Conducted daily touchpoints and weekly staff meetings
  • Led teams to fully investigate quality processes to identify deficiencies and opportunities
  • Provided mentoring and project assignments to support individual career development opportunities
  • Used strong analytical and problem-solving skills to develop effective solutions for challenging situations
  • Provided Galaxy claim samples for Focus Audits based on specific criteria and needs of audit requester
  • Analyzed data to identify defect trends, prepared monthly results presentations to drive defect remediation
  • Identified issues, analyzed information and provided solutions to problems.

REPORT ANALYST

UnitedHealthcare
05.2013 - 06.2022
  • Review internal systems and processes for streamlining opportunities to increase efficiency
  • Analyze claims data to identify error defect trends for multiple platforms including UNET, CAMS and USP
  • Compile professional presentations highlighting audit findings and defect remediation plans
  • Collaborate cross-functionally to coordinate effective solutions to systemic problems, resulting in direct reductions in error and rework rates.
  • Automated multiple reporting tasks through creation of reporting tools.
  • Produced detailed and relevant reports for use in making business decisions.
  • Continuously assessed current reporting techniques and developed improvements to boost accuracy.

QUALITY SUPERVISOR

UnitedHealthcare
10.2005 - 05.2013
  • Oversaw department of 20 claims auditors by supervising daily operations, providing support, and coordinating all personnel needs
  • Conducted daily touchpoints and weekly staff meetings
  • Supervised and directed quality personnel through effective mentoring, coaching and work delegation
  • Supported multiple audits and led teams to fully investigate quality control processes to identify deficiencies and opportunities
  • Provided mentoring and project assignments to support individual career development opportunities.

Education

High School Diploma -

Mohawk High School
Bessemer, PA

Skills

  • Quality and Claim Supervision
  • Root Cause Analysis
  • Critical Thinking
  • Galaxy and UDW Certified
  • Error Trending & Process Improvement
  • Six Sigma Methodologies
  • Excellent Written and Interpersonal Communication
  • Cross-Functional Collaboration
  • Proficient in all Microsoft applications
  • Experience with Tableau and Power BI
  • Working independently and collaboratively in team environment

Certification

  • Galaxy Certification- 2013
  • UDW Certification- 2017
  • Leaders In Action Certificate - 2022


Timeline

QUALITY SUPERVISOR

UnitedHealthcare
06.2020 - Current

REPORT ANALYST

UnitedHealthcare
05.2013 - 06.2022

QUALITY SUPERVISOR

UnitedHealthcare
10.2005 - 05.2013

High School Diploma -

Mohawk High School

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Gina Trosky