HOLLY NAPIER
Columbus,Georgia
Summary
My goal is to be a part of an industry that helps others to be healthier, better, stronger and happier. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
20
20
years of professional experience
Work History
Business Change Manager (SME)
ELEVANCE HEALTH
01.2023 - 10.2023
- Handled complex end user issues and requirements to determine optimal needed solutions and outcomes
- Assisted IT and programmers to ensure the necessary elements developed for design and provided testing results
- Assisted as Subject Matter Expert for guidance to project users
- Provided the needed direction with questions and concerns during development.
Operations Analyst
ELEVANCE HEALTH
11.2019 - 01.2023
- Handled inquiries, grievances and appeals within specified timeframes established by either regulatory/accreditation agencies or customer needs
- Aided various units-claims, regulatory, provider inquiry and others for resolution.
Claims Processor II
ANTHEM
08.2015 - 11.2019
- Keyed and processed professional medical and dental claims within guidelines to ensure proper adjudication and assisted in overflow areas such as, refund inquiries and correspondence
- Met productivity, quality and schedule adherence.
CCA II/Claims Processor II/Multi
ANTHEM
01.2010 - 08.2015
- Handled customer calls and inquiries including billing, benefits and eligibility
- Met productivity, quality and schedule adherence
- Proficiently managed correspondence with resolution, processed claims according to specified procedures and standards.
CCA II
BCBSGA
11.2003 - 01.2010
- Handled customer calls and inquiries including billing, benefits and eligibility
- Met productivity, quality and schedule adherence
- Proficiently managed correspondence and resolution.
Education
Skills
- Business process improvement
- Technical understanding
- Influencing skills
- Organizational change management
- Change Strategy Development
- Data Collection
- Business Analysis
- Friendly, Positive Attitude
- Teamwork and Collaboration
- Customer Service
- Problem-Solving
- Time Management
Applications
- WGS
- Java
- InterAct
- UAT Tester
- SQL
- Sharepoint
- WCF
- EDI
- JIRA Biz & Enterprise
- OIA Ad-Hoc Data Reporting
- Pega application-PCM & NextGen
- Cotiviti
- ACMP
- M360
- Streamline
- Qcare
- CCB
- Nintex
- SPS
- AS400
Cover Letter
To whom it may concern, To me, the ideal environment is, a place where innovative ideas, workflow restoration and paying forward ‘the knowledge’ is the standard. My interests are, in the processes of the platforms and applications, a breakdown of steps, reverse engineered-to analyze for improvements or corrections and being innovative-seeing what it could be, following through with those innovations to a more efficient process. One of my goals is for all processes and tasks to flow smoothly, with the result of meeting the needs of all our customers, both internal and external. Being a collaborator, with those like-minded is what I am looking for in the next phase of my time in this industry. Our products speak for themselves but knowing how to facilitate them effectively is what speaks to our members and providers alike. The volume of respect we gain from them is solely based on how we take care of each other’s needs. Our members desire that type of security. This is the type of team I am looking for. I have worked over 20 years through the direct service lines to processing claims, worked inquiries and correspondence and went through multiple migrations- platform to platform and application to application. I have great interests and aspirations to bring to a growing area and I look forward to being among the selected applicants. Best regards, Holly Napier 706-718-3870 hollyn_ga@yahoo.com
Timeline
Business Change Manager (SME)
ELEVANCE HEALTH
01.2023 - 10.2023
Operations Analyst
ELEVANCE HEALTH
11.2019 - 01.2023
Claims Processor II
ANTHEM
08.2015 - 11.2019
CCA II/Claims Processor II/Multi
ANTHEM
01.2010 - 08.2015
CCA II
BCBSGA
11.2003 - 01.2010
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