Michelle Campbell
Hartford,CT
Summary
Results-driven Senior Electronic Eligibility Analyst at Cigna with expertise in automated eligibility processes and compliance regulations. Proven track record in enhancing accuracy through process improvements and effective cross-functional collaboration. Skilled in data management systems and client communication, ensuring seamless enrollment facilitation and adherence to internal standards.
Overview
17
17
years of professional experience
Work History
Senior Electronic Eligibility Analyst
Cigna
09.2022 - 03.2025
- Collaborated with cross-functional teams to address and resolve eligibility inquiries effectively.
- Developed and maintained documentation of eligibility processes
- Implemented process improvements that enhanced accuracy in eligibility assessments.
- Conducted periodic audits of case files to ensure adherence to internal standards and regulations.
- Utilized Cigna's internal systems to track and manage case statuses efficiently.
- Proficient in using the 834 5010 system for the automated eligibility process.
- Handled flat files, including the 2700 format, for clients using this automated eligibility process.
- Corrected errors for automated failed files, and requested a new file from the file sender.
Enrollment Specialist
Aetna
05.2008 - 01.2022
- Facilitated enrollment processes for new members, ensuring compliance with state and federal regulations.
- Managed employers' inquiries, providing timely and accurate information regarding enrollment status and plan options.
- Collaborated with cross-functional teams to streamline enrollment workflows, enhancing overall efficiency.
- Manually processed enrollments for Cobra enrollees in various systems depending on urgency.
- Applied checks, money orders, and Aetna's billing system to members' accounts.
- Used Salesforce for documentation of inbound calls from employers.
Education
Bachelor of Science - Information Technology
American InterContinental University
Buckhead, GASkills
- Process documentation
- Cross-functional collaboration
- Compliance regulations
- Data management systems
- Automated eligibility processes
- Flat file handling
- Error correction procedures
- Enrollment facilitation
- Client communication
- Salesforce utilization
- Billing system application
- Verbal communication
- Microsoft office
- Data entry
Timeline
Senior Electronic Eligibility Analyst
Cigna
09.2022 - 03.2025
Enrollment Specialist
Aetna
05.2008 - 01.2022
Bachelor of Science - Information Technology
American InterContinental University