Kristie Moore
Nineveh,IN
Summary
Hard-working Supervisor that is an organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Excellent communication and listening skills
Overview
41
41
years of professional experience
Work History
International Claim Supervisor
Optum
01.2017 - 05.2024
- Reconciled and paid Invoices.
- Supervised employees.
- Oversaw daily operations of the department, ensuring smooth workflow and timely completion of tasks.
- Handled customer complaints, resolved issues, and adjusted policies to meet changing needs.
- Evaluated employee performance and coached and trained to improve weak areas.
- Enhanced communication within the team by holding regular meetings and encouraging open dialogue among all members.
- Conducted regular reviews of operations and identified areas for improvement.
Account Manager
Optum
01.2007 - 01.2017
- Audited claims, enrollment, resolved customer service complaints, prepared monthly client savings reports, sent weekly funds request reports, prepared monthly NY and MA State surcharge reports, sent discount proposals on all claims that did not have a PPO contract, verified coverage benefits, answered claim status calls.
- Addressed problems with accounting, billing, and service delivery to maintain and enhance client satisfaction.
- Increased client satisfaction by building strong relationships and addressing their needs promptly.
Claims Representative
Optum
01.2006 - 01.2007
- Processed/audited claims under $1k for every client (international and Maritime) which represented 75% of all the claims received
- Worked 20 hours at home and 20 hours in the office.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Enhanced claim processing efficiency by streamlining workflows and implementing best practices.
- Negotiated favorable settlements with claimants, resulting in cost savings for the company.
- Served as a subject matter expert on specialized claims, providing guidance and support to other team members when needed.
International Claims Supervisor
Optum
01.2001 - 01.2006
- Supervised six Claims Representatives, prepared and conducted yearly performance reviews, trained all new employees on the claims processing system, supervised the on-call staff.
- Assisted in the recruitment and selection of new claims adjusters, ensuring they possessed the necessary skills and expertise to excel in their roles.
- Managed a diverse caseload, prioritizing tasks effectively to meet strict deadlines and maintain quality standards.
- Negotiated disputed bills or invoices, achieving successful resolution.
Quality Controller
Optum
01.1994 - 01.2001
- Audited claim files to ensure the proper office procedures followed, created office procedure manual, audited all claims over $10k to release for payment.
- Developed comprehensive quality control documentation, providing clear guidelines for staff adherence.
Claims Adjuster
Optum
01.1992 - 01.1994
- Processed medical claims, answered claim status calls.
- Achieved cost savings through successful subrogation efforts, recovering funds from responsible parties in various claims scenarios.
Claims Assistant
Optum
01.1990 - 01.1992
- Answered claim status calls, sorted incoming faxes, sent outgoing faxes for the Claims Adjusters, set up claim files, opened/identified/matched mail to claim files.
Accounting Representative
Optum
01.1983 - 01.1990
- Record monthly insurance premiums into client's accounts, reconcile monthly reports, calculate broker commissions.
Education
Ivy Tech Community College
Indianapolis, INSkills
Training and mentoring
Goal-Oriented Thrive in fast-paced environment
Staff Management/Conflict Management
Complex Problem-Solving
Idea Development and Brainstorming
Strong work ethic, professional, and organizational skills
Ability to work both independently and as part of a team
Medical Terminology & medical claims processing
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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References
Available upon request
Accomplishments
- Supervised team of 6 staff members.
- Used Microsoft Excel to develop inventory tracking spreadsheets.
- Resolved product issue through consumer testing.
References
Available upon request
Carolyn Partsch, 240-446-4327
Peggy Homeier, 317-617-8157
Kim Bell, 317-696-7745
Work Preference
Work Type
Full TimeLocation Preference
RemoteImportant To Me
Company CultureWork-life balanceHealthcare benefits401k matchPaid time offQuote
Life is something that happens to you while you’re making other plans.
Margaret Milar
Timeline
International Claim Supervisor
Optum
01.2017 - 05.2024
Account Manager
Optum
01.2007 - 01.2017
Claims Representative
Optum
01.2006 - 01.2007
International Claims Supervisor
Optum
01.2001 - 01.2006
Quality Controller
Optum
01.1994 - 01.2001
Claims Adjuster
Optum
01.1992 - 01.1994
Claims Assistant
Optum
01.1990 - 01.1992
Accounting Representative
Optum
01.1983 - 01.1990
Ivy Tech Community College
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