Summary
Overview
Work History
Education
Skills
Timeline
Generic

Maria Wimberly

Lancaster,NY

Summary

Configuration management professional with deep knowledge in system setup, software deployment, and process optimization. Proven track record in driving efficiency, ensuring compliance, and maintaining system integrity. Strong collaborator, adaptable to changing needs, and consistently delivers reliable results. Proficient in troubleshooting, technical documentation, and cross-functional teamwork.

Overview

5
5
years of professional experience

Work History

Sr. Implementation & System Configuration Specialist

International Benefit Administrators
04.2024 - Current
  • - Lead benefit plan build and configuration using Javelina and HealthPAC platforms
  • - Design, validate, and test medical and dental benefit plans to ensure compliance and accuracy
  • - Develop auto-adjudication logic to streamline claims processing and enhance operational efficiency
  • - Serve as the primary contact for claims platform issues; troubleshoot and resolve system concerns in collaboration with cross-functional teams

Benefit Configuration Specialist II

Centivo
04.2022 - 04.2024
  • - Analyzed plan documents and standards to create accurate configuration blueprints
  • - Built, validated, and tested medical benefit plans in core admin systems
  • - Specialized in Javelina and HealthPAC for benefit setup, adjudication rules, and integration
  • - Partnered with cross-functional teams to support end-to-end benefit configuration and deployment

Claims Analyst

Aither Health
08.2020 - 04.2022
  • Maintained strict confidentiality with all personal data as per company guidelines.
  • Managed high-volume caseloads, prioritizing tasks to ensure timely completion of all claims.
  • Maintained compliance with industry regulations and company policies while managing sensitive client information and claims records.
  • Demonstrated a high level of accuracy and attention to detail in reviewing claim documentation for approval or denial decisions.

Customer Service Representative

Aither Health
08.2020 - 04.2022
  • Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
  • Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
  • Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
  • Responded to customer requests for products, services, and company information.

Education

Associate of Applied Science - Medical Administrative Assistant

Bryant & Stratton College
Orchard Park, NY
01.2014

Skills

  • - Benefit Administration: Expertise in self-funded health plans and regulatory compliance
  • - Medical Coding: Proficient in ICD-9/10, CPT, and HCPCS
  • - Claims Systems: Advanced knowledge of Javelina and HealthPAC platforms
  • - Process Optimization: Strong background in building auto-adjudication rules and reducing claims processing time
  • - Attention to Detail: Highly accurate with documentation, coding, and system configuration
  • - Collaboration: Effective communicator and collaborator across technical and non-technical teams

Timeline

Sr. Implementation & System Configuration Specialist

International Benefit Administrators
04.2024 - Current

Benefit Configuration Specialist II

Centivo
04.2022 - 04.2024

Claims Analyst

Aither Health
08.2020 - 04.2022

Customer Service Representative

Aither Health
08.2020 - 04.2022

Associate of Applied Science - Medical Administrative Assistant

Bryant & Stratton College

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