Alex Mullins
Kansas City,MO
Summary
Dedicated and results-driven Claims Administrator with a decade of comprehensive experience in managing and streamlining claims processes. Known for a meticulous attention to detail and a steadfast commitment to efficiency, I have honed my skills in navigating complex claim procedures with precision and accuracy. Throughout my career, I have consistently delivered exceptional results by optimizing workflows, implementing strategic improvements, and ensuring compliance with regulatory standards. My adeptness in analyzing data and identifying trends allows me to proactively mitigate risks and enhance overall operational effectiveness. With a proven track record of success in claims administration, I am poised to contribute my expertise to drive continued excellence in any dynamic environment.
Overview
11
11
years of professional experience
Work History
Claims Administrative I
- Processed approximately 500 claims weekly, ensuring timely receipt, proper documentation, and forwarding to the designated coordinator
- Leveraged Cherwell platform proficiently to retrieve appeals and efficiently allocate them among the team for review and processing
- Managed ongoing claims administration, including the systematic archival of 25 boxes every quarter and coordinating offsite storage solutions as needed
- Organized appeals systematically within the J drive, arranging them chronologically to facilitate streamlined access and retrieval
- Generated correspondence tailored to providers in Texas, promptly notifying them of claim receipt and processing status to maintain transparent and effective communication channels.
Claims Administrative II
Evicore (Cigna)
05.2013 - Current
- Assess and adjudicate 200-300 claims per day, meticulously assigning them to the appropriate department for processing
- Collaborate closely with appeal coordinators to facilitate the thorough and accurate processing of appeals and claims
- Exercise discernment to redirect claims to the appropriate department when necessary, ensuring swift and efficient resolution
- Liaise with Cigna representatives to procure supplementary information vital for comprehensive claim investigation and departmental assignment
- Assume oversight responsibility for all claims throughout the processing pipeline, preemptively rectifying errors prior to submission for review
- Maintain a high level of productivity and efficiency while working remotely, consistently surpassing production targets and qualifying for monthly performance incentives.
Education
Bachelor of Arts - Park and Recreation Management
University of Mississippi
12.2004
Skills
- Claims Adjudication
- Appeal Processing
- Comprehensive claim investigation
- Error Rectification
- Production Targets
- Technical aptitude
- Document Control
- Regulatory Compliance Adherence
- Teamwork and Collaboration
- Policy analysis
- Excellent administrative abilities
- Records Management
Timeline
Claims Administrative II
Evicore (Cigna)
05.2013 - Current
Claims Administrative I
Bachelor of Arts - Park and Recreation Management
University of Mississippi