Jennifer Lemons

• With over a decade of experience in the health insurance industry, my journey from Claims Rep to Financial Operations Specialist 111 at Elevance Health, formerly Anthem, Inc, reflects a deep commitment to operational excellence Specializing in manufacturing process improvement, I've had a sharp proficiency in vendor relations and operations At the core, my mission is to streamline processes and deliver value, aligning with Elevance Health's culture of continuous improvement As we advance in healthcare efficiency, my role leverages these competencies to drive change and foster innovation
• I am a reliable and highly motivated individual who is driven by integrity I take great pride and personal ownership in my quality and overall performance I am a team player who is always willing to help and support others I am detailed and goal oriented with strong organizational and time management skills I am looking for a new opportunity with a company that will lead my dedication and positive attitude to professional and personal growth
• Assist Vendors: Audit their audits to ensure their invoices to Elevance are accurate Process Accounts payable checks to the vendors Attach the appropriate invoices with their payment Make sure all payments are accurate before they are submitted to upper management for approval

Recovery Specialist

Generated overpayment letters to recover Anthem payment system reimbursements for various cases Executed collection strategies to secure settlement funds for anthem payment system program reimbursements Compiled and analyzed monthly reports, monitoring priority workloads for facility and provider regional offices Served as a liaison for facility and provider regional offices and our contracted vendors on priority projects Conducted training sessions for our contracted vendors on recovery processes and compliance

Customer Service

Respond to customer questions via telephone and written correspondence regarding insurance eligibility and billing Research and analyzes data to address operational challenges and customer service issues Seek, understand, and respond to the needs and expectations of internal and external customers

Claims

Responsibilities: Keyed, processed and/or adjusted health claims in accordance with claims policies and procedures Fully proficient in all key areas; performed many complex functions I participated in claims workflow projects Primary duties included but were not limited to: Responded to telephone and written inquiries and initiated steps to assist callers regarding issues relating to the content or interpretation of benefits, policies and procedures, provider contracts, and adjudication of claims Adjusted, voided, and reopened claims on-line within guidelines to ensure proper adjudication Had customer/client contact Assisted with training of staff Worked without significant guidance