Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Katherine Dean

Cicero,NY

Summary

Detail-oriented claims professional with 13 years of experience in processing and managing claims. Highly skilled in data entry, negotiating settlements, while delivering exceptional customer service. With an extensive knowledge of medical coding terminology including CPT, HCPC, and ICD, alongside a thorough understanding of medical terminology. Seeking an opportunity within the insurance industry where I can utilize my expertise to efficiently handle claims, deliver positive outcomes, and contribute to a dynamic team.

Overview

16
16
years of professional experience

Work History

Claims Associate

The Hartford
Syracuse, NY
03.2022 - 06.2024
  • Negotiated and settled state disputes ranging from $100 to $300,000, demonstrating a track record of successful resolutions across a variety of financial and regulatory issues.
  • Collaborated closely with legal counsel to present detailed settlement proposal, ensuring comprehensive understanding on dispute resolutions.
  • Conducted thorough investigations into requests from various states, identifying key insights and gathering necessary information to inform decision-making processes.
  • Collaborate with multiple departments within workers comp to devise solutions, enhance efficiency, and minimize future disputes.
  • Report and identify patterns to reduce and prevent the likelihood of future disputes and associated costs.
  • Designed and updated multiple job aids to streamline processes and ensure alignment with current policies and procedures.
  • Updated databases and spreadsheets to reflect total company savings based on settled disputes.
  • Obtain PPO (Preferred Provider Organization) contracts to assist in dispute determinations.
  • Analyzed and addressed escalated claims to resolve issues quickly.

Medical Billing Examiner

The Hartford
Syracuse, NY
08.2010 - 03.2022
  • Evaluate and reimburse provider medical bills in adherence to state standards, guidelines, and medical protocols.
  • Initiate outbound calls to gather additional information, ensuring invoices are processed within designated turnaround times.
  • Provide mentorship to new team members and facilitate side by side training sessions for visiting company personnel.
  • Accurately coding services, procedures, diagnoses, and treatments
  • Enter incoming medical bills manually into Smartview system, maintaining meticulous attention to detail and data integrity.
  • Reduced processing time by implementing streamlined workflows for more efficient application reviews.

Medical Billing Examiner

The Hartford
Syracuse, NY
01.2008 - 08.2010
  • Handle over 50 calls daily in a fast-paced, high-volume call center environment, managing intake and inquiries related to short-term disability leave.
  • Address customer inquiries regarding their claim status, providing accurate information and resolving concerns promptly.
  • Manually input data pertaining to disability claims.
  • Coordinate with medical providers to obtain necessary documentation, ensuring the active processing of claims.
  • Provided one-on-one job shadowing to mentor and train new hires.

Education

Bachelor of Arts - Public Relations And Communications

SUNY Buffalo State
Buffalo, NY
01.2029

Associate of Arts - Humanities

Onondaga Community College
Syracuse, NY
05.2005

Skills

  • Claims Processing
  • Time Management
  • Decision-Making
  • Team Collaboration
  • Conflict Resolution
  • Settlement determinations
  • Data Integrity
  • Critical Thinking
  • Adaptability

Accomplishments

While employed at The Hartford I actively participated in a “Greenbelt” project involving various levels of staff within the company. Our goal with this project was to streamline operations and minimize redundancies within the system. As part of this initiative, I proposed system updates to incorporate automatic approvals aligned with the claimants’ diagnosis(s). This enhancement aimed to reduce handler workload, enabling them to dedicate their time to other critical tasks. Additionally, I was involved in “Hart Happenings,” a company club within the workers’ compensation department. Each month, members gathered to compile content for quarterly emails featuring slides showcasing new hires, team member spotlights, and team member photos of family, pets and hobbies. This initiative played a key role in fostering connectivity and engagement amongst team members while working remotely full time.

Timeline

Claims Associate

The Hartford
03.2022 - 06.2024

Medical Billing Examiner

The Hartford
08.2010 - 03.2022

Medical Billing Examiner

The Hartford
01.2008 - 08.2010

Bachelor of Arts - Public Relations And Communications

SUNY Buffalo State

Associate of Arts - Humanities

Onondaga Community College
Katherine Dean