KALEYA JACOBS
Toledo,Ohio
Summary
Seasoned Business Analyst offering Three years of Claims industry success. Expert on business and systems requirements, user acceptance testing and end-user training. Accomplished at leveraging past lessons to inform future decision-making.
Overview
12
12
years of professional experience
Work History
Business Analyst
Wipro Limited
05.2020 - 01.2023
- Analyze and interpret medical and dental claims prior to entering provider details into claims processing system
- Update or add provider records into the claim system
- Must consistently meet or exceed departmental productivity and quality goals
- Provide support to other team responsible for configuring networks and contracts as needed
- Update documentation and reference materials as needed
- Actively participate in team meetings
- Actively participate in client facing meetings and communicate directly with assigned contacts as needed
- Provide feedback to the team leadership as required.
- Developed high-quality documentation to support training efforts, helping employees fully understand new systems and procedures.
Senior Claims Associate
VSP Global
07.2018 - 12.2019
- Explaining EOP information
- Resolving customers' complaints while identifying problems and taking appropriate corrective action
- Demonstrated professional etiquette and manners, improving 30% positive feedback forthwith
- Reduced customer complaints by 30% through escalated grievance resolution procedure
- Assisting with claim corrections & correcting payouts
- Hire, onboard and train new employees, including instructing on food safety, customer service standards and operations
- Increase customer satisfaction ratings by [number %] in first year of service.
Human Resources Assistant
JEGS High Performance
10.2015 - 03.2016
- Excellent customer service skills and positive attitude as demonstrated by receiving employee of the month in four consecutive months
- Open and maintain customer accounts by recording account information
- Observing and assisting with first day orientation
- Preliminary phone screening for interviews
- Resolve product or service problems by clarifying the customer's complaint; determining the cause of the problem; selecting and explaining the best solution to solve the problem; expediting correction or adjustment; following up to ensure satisfaction
- Recommend potential products or services to management by collecting customer needs information and analyzing customer needs
- Prepare product or service reports by collecting and analyzing customer information
- Emailing i9 paperwork
- Administering drug screening.
Provider Maintenance Specialist
Hurley Medical Center
10.2010 - 06.2013
- Proactively identified potential issues or discrepancies in provider records, taking corrective action as needed to maintain data integrity.
- Analyzed user requirements and developed solutions to meet needs.
- Developed and maintained strong client relationships to deliver exceptional customer service and problem resolution.
- Provided basic end-user troubleshooting and desktop support.
- Assisted in audits of provider files, ensuring adherence to internal policies as well as industry regulations and standards.
Education
GED -
Griffin Tech College
Griffin, GA05.2009
Skills
- Desktop support
- Communications
- Process improvement
- Organization
- Customer service expert
- Data entry
- MS Office
- Technical issues analysis
- Team building
- Problem resolution
- Customer service
- Claims Corrections
- Procedure Coding
- Excel
- CPT Coding
- Time Management
- Interpersonal Communication
- Data Analysis
- Policy Knowledge
- Active Listening
- Stress Management
- Decision Making
- Teamwork and Collaboration
Languages
English
Full Professional
Timeline
Business Analyst
Wipro Limited
05.2020 - 01.2023
Senior Claims Associate
VSP Global
07.2018 - 12.2019
Human Resources Assistant
JEGS High Performance
10.2015 - 03.2016
Provider Maintenance Specialist
Hurley Medical Center
10.2010 - 06.2013
GED -
Griffin Tech College
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