LaShawna Johnson
Tampa,FL
Summary
Dynamic Client Service Analyst with a proven track record at Metlife and Centene Corporation, showcasing leadership in claims operations and excellence in customer service. Expert in Microsoft Office Suite and adept at data analysis, I led projects that significantly improved business processes, mentoring teams towards achieving department goals. My approach combines effective people management with strategic client retention strategies.
Overview
16
16
years of professional experience
Work History
Client Service Analyst
Metlife
Tampa , FL
08.2024 - Current
- Ability to communicate clearly and professionally, both verbally and in writing.
- Ability to provide excellent customer service and relationship management.
- Ability to work in a team environment, and assist other areas when needed.
- Ability to perform multiple tasks, set schedules, and prioritize to meet both internal and external deadlines.
Claims Operations Supervisor
Centene Corporation
Tampa, USA
08.2018 - 12.2023
- Company Overview: Formally, WellCare Health Plans
- Led team of 15 senior claims administration associates processing healthcare provider resolution claims
- Served as an operational leader by creating, implementing and approving operational changes through documentation and process flows
- Managed and analyzes key metrics and while maintaining ad hoc reports to ensure team and/or individuals are on target
- Facilitated consistent performance improvement meetings, in order to gage direct reports successes and opportunity areas in order exceed department goals
- Assisted associates with claims processing, and understanding provider contracts, contract configuration, and escalated provider inquiries and implements improvement plans
- Collaborated to solve complex problems and implement innovative solutions with broad impact on the business
- Developed and led projects for business process improvement
- Formally, WellCare Health Plans
Claims Operations Team Lead
Centene Corporation
Tampa, USA
10.2017 - 08.2018
- Company Overview: Formally, WellCare Health Plans
- Served as Subject Matter Expert for Claims Operations Teams supporting 15+ associates
- Led as primary contact for provider Relations for escalated provider issues
- Mentored 15 associates by providing data driven feedback and performance coaching
- Thoroughly researched complex issues across multiple databases and applied appropriate action to resolve issues within established service level agreements
- Applied comprehensive knowledge of and understanding of provider contracts while claims processing within the Xcelys system
- Collaborated with leadership to manage daily production workflow within the department focusing on maximizing productivity
- Formally, WellCare Health Plans
Senior Provider Resolutions Specialist
Centene Corporation
Tampa, USA
03.2009 - 10.2017
- Company Overview: Formally, WellCare Health Plans
- Served as Subject Matter Expert, resolving and processing escalated healthcare provider solutions
- Served as Team Subject Matter Expert with institutional and professional medical claims for all lines of businesses
- Assisted in helping team members with questions or escalated provider, charged to assist in de-escalation of the call if needed
- Provided quality service while speaking with the providers regarding complex escalated claims disputes
- Investigated and facilitated resolutions to claims issues, by networking with multiple operational areas in order to research, adjust and complete root cause analysis on medical claims
- One of 4 chosen out of 37 representatives to help launch new Concierge Models for providers
- Formally, WellCare Health Plans
Education
High School Diploma -
Thomas Jefferson Highschool
Tampa, FLSkills
- Leadership
- Microsoft Office Suite
- Microsoft SharePoint
- Workday
- Tableau
- Data analysis
- Project Management
- People management
- Complaint handling
- Client retention strategies
- Account management
Timeline
Client Service Analyst
Metlife
08.2024 - Current
Claims Operations Supervisor
Centene Corporation
08.2018 - 12.2023
Claims Operations Team Lead
Centene Corporation
10.2017 - 08.2018
Senior Provider Resolutions Specialist
Centene Corporation
03.2009 - 10.2017
High School Diploma -
Thomas Jefferson Highschool
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