Summary
Overview
Work History
Education
Skills
Timeline
Generic

Michelle Powis

Newark

Summary

To obtain a position within a that fosters an environment where I can work independently but likewise allows me to be an essential part of a team.

Overview

26
26
years of professional experience

Work History

Analyst, Quality Audit Control Ops

Aetna
04.2020 - Current
  • Audit Prepayment claims in QNXT with a higher level of complexity to validate financial accuracy.
  • Audit stratified and post payment claims for financial accuracy.
  • Specialized target audits/Internal Project Audits.
  • Exceed my daily production goals with exceptional accuracy.
  • Work from Home

System Analyst-Testing

Aetna
10.2007 - 04.2010
  • Develop and execute comprehensive testing processes for compliance and audit purposes.
  • Preparation and maintenance of a comprehensive test plan to provide quality audits for vendor contracts.
  • Monitor compliance and audit findings to ensure that they adhere to contractual guidelines.
  • Validate test results, documents discrepancies, and follow through with resolutions to ensure all issues are resolved.
  • Communicate with peers and management with audit findings.

Technical Integrated Claims Specialist

Fleet Credit Card Services
10.2004 - 10.2007
  • Review and process medical claims from various providers within established guidelines.
  • Ensure compliance with HIPPA and other federal and/or state laws.
  • Research mail correspondence claim errors and reprocess for correct payment to provider.
  • Communicate with providers to resolve billing issues and discrepancies.

Senior Operations

Fleet Credit Card Services
09.1999 - 10.2004
  • Analyze and research bank accounts to ensure compliance with the bank's credit balance policy.
  • Approve and issue credit balance refunds to clients.
  • Review credit card account for fraud related issues.
  • Initiate and process adjustments to transfer funds to clients.
  • Communicate with other banking institutions to resolve any applicable issues.
  • Assessed fees to credit card for returned credit card payments.

Education

High School -

Glasgow High School
Newark, DE
01.1995

Skills

  • Problem-solving skills
  • Effective time management

Timeline

Analyst, Quality Audit Control Ops

Aetna
04.2020 - Current

System Analyst-Testing

Aetna
10.2007 - 04.2010

Technical Integrated Claims Specialist

Fleet Credit Card Services
10.2004 - 10.2007

Senior Operations

Fleet Credit Card Services
09.1999 - 10.2004

High School -

Glasgow High School

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