Janie Stentz
Omaha,NE
Summary
Motivational Team Leader skilled in designing and following production schedules. Offers proven history of maximizing team productivity to meet targets. Dedicated to employee safety and proactive assignment, schedule, and personnel management.
Overview
34
34
years of professional experience
Work History
Team Lead, Senior Claims Analyst
Blue Cross Blue Shield of Nebraska
03.2016 - Current
- Demonstrates knowledge and proficiency on Inter-Plan Teleprocessing System (ITS), QNXT, Citrix Mainframe, Blue2 and Claim Administration claim systems, utilizing the Plan Connexion platform, Eligibility, HIPAA, Remittance Advice
- Maintained LDLA quality standing for Blue Card claims
- Complete Host audit and process on claims
- Write-up root causes of on-going issues with Health Edge processing system
- Answered Provider calls, handled questions and resolved any issues
- Answer Plan-to-Plan calls to resolve any issues
- Provide guidance, supervision, support and daily work load for staff
- Wrote up system issues for IT department to remediate claims processing issues
- Maintained quality assurance and assisted in ongoing training.
10.2019 - 02.2020
- Responsible for creating test cases for institutional and professional claims to ensure code delivered from vendor was accurately adjudicating claims
- Claims utilized the Plan Connexion system for BlueCard claims, and testing had to ensure all aspects of the system were working for Host and Home Plans using the Agile methodology
- After implementation of the system, continued to test new upgrades and remediation of 'broken' code
Educational Assistant
Omaha Westside High School
09.2008 - 03.2016
- Assist special education teacher in a classroom environment, and provide student instruction and support with educational goals.
Senior Patient Account Representative
Nebraska Methodist Health System
03.1998 - 09.2002
- Provide customer service, direct patient contact for claims, account and insurance questions, audit patient accounts, educate patients on billing process, enter data, and update patient records.
Secondary Billing Representative
Nebraska Methodist Health System
01.1998 - 03.1998
- Bill insurers, audit patient accounts, and maintain medical provider records.
Lead Underwriting Assistant
Equifax
06.1995 - 01.1998
- Process and pre-underwrite health and life insurance coverage applications.
Administrative Assistant
J.L. Kizer & Associates
09.1990 - 06.1995
- Assist sales associates with life insurance applications and perform general office administration duties.
Education
High School Diploma -
Omaha Central High School
Omaha, NE08.1986
Skills
- Account reconciliation
- Billing
- Collections
- Data entry
- Customer service
- Multi-tasking
- Leadership
- Communication
- Decision-making
- Computer proficiency
- Mentoring/coaching
Timeline
10.2019 - 02.2020
Team Lead, Senior Claims Analyst
Blue Cross Blue Shield of Nebraska
03.2016 - Current
Educational Assistant
Omaha Westside High School
09.2008 - 03.2016
Senior Patient Account Representative
Nebraska Methodist Health System
03.1998 - 09.2002
Secondary Billing Representative
Nebraska Methodist Health System
01.1998 - 03.1998
Lead Underwriting Assistant
Equifax
06.1995 - 01.1998
Administrative Assistant
J.L. Kizer & Associates
09.1990 - 06.1995
High School Diploma -
Omaha Central High School
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