Summary
Overview
Work History
Education
Skills
References
Timeline
Generic

Misti Elledge

Yukon

Summary

Dynamic professional with extensive experience at Humana in claims processing and resolution. Proven ability in data analysis and problem-solving, consistently achieving productivity benchmarks. Recognized with 13 STAR awards for excellence. Skilled in training development and documentation management, fostering team growth and operational efficiency.

Overview

15
15
years of professional experience

Work History

Claims Research & Resolution Representative 3

Humana
Louisville
06.2021 - Current
  • Started as an Inbound Contact Center Representative, moved to a Correspondence Representative 2, before being promoted to Claims Research & Resolution Representative 3.
  • Processed claims in compliance with quality, production standards, and applicable regulations.
  • Managed workload to meet productivity and quality benchmarks consistently.
  • Resolved complex issues regarding denied, underpaid, or overpaid claims through effective negotiation with payers.
  • Assisted customers with inquiries about claim status and company services via telephone.
  • Utilized various computer programs, including CRM, CIS Pro, CGX, HIVs, and CAS, for claims processing.
  • Supporting through research, analysis, and documentation of Market CRU claims.
  • Exercising discretion and judgment by prioritizing requests. Interpreting and adapting procedures.
  • Received 13 STAR awards.
  • Committee member for NRG NA&I Ally, and NRG NA&I Healthier Community.

Office Manager

Gayla's Tag Agency
Blanchard
08.2020 - 05.2021
  • Managed daily office operations and maintained efficient workflow.
  • Maintained accurate records of transactions and client information.
  • Handled customer inquiries and resolved issues promptly and professionally.
  • Processed motor vehicle, manufactured homes, trailers, and boat titles, and registrations.
  • Provided excellent customer service in the office, and took inbound calls for customers with questions regarding titling, registrations, and driver’s licenses.
  • Worked with local dealerships regarding title work, processing liens, and vehicle information request forms. Scheduling appointments and follow-ups for state-issued driver’s licenses.

Manager Trainee

The Chickasaw Nation
Ada
10.2017 - 05.2020
  • Started as a Facility Services Supervisor, moved to Cage Cashier, before being promoted to Manager Trainee.
  • Completed schedules, shift reports, and other business documentation.
  • Entered time in Kronos and monitored the continuing education and certifications of employees.
  • Evaluated employee performance, and developed improvement plans. Trained and mentored all new personnel to maximize the quality of service and performance.
  • Collaborated with maintenance and event concierge to schedule repairs.
  • Demonstrated servant leadership by working alongside employees, helping them accomplish the goals of the team, and providing them with the tools they need to complete tasks.
  • Ensured proper Title 31 measures were followed.
  • Trained in every department for the Chickasaw Nation Commerce Department.
  • Completed the Chickasaw Nation University classes.

Training Coordinator

Tarrant County Tax Office
Fort Worth
01.2011 - 10.2017
  • Developed training programs for new employees in the motor vehicle department.
  • Coordinated logistics for training sessions, including scheduling and materials preparation.
  • Facilitated workshops to enhance employee skills and knowledge retention.
  • Conducted needs assessments to identify training gaps and opportunities.
  • Collaborated with department heads to align training initiatives with company goals.
  • Implemented feedback mechanisms to improve training delivery and content.
  • Managed training records and maintained compliance documentation efficiently.
  • Assisted in onboarding processes for new hires across multiple locations.
  • Maintained accurate records of all trainings conducted.
  • Developed training materials and documents such as manuals, handouts, exercises and facilitator guides.
  • Evaluated employee performance before, during, and after training sessions.
  • Updated existing curriculums based on changes in technology or industry standards.
  • Oversaw the daily office operations for a staff of 45 employees.

Education

High School Diploma -

Newcastle High School
Newcastle, OK
05-1989

Skills

  • Claims processing
  • Documentation management
  • Data analysis
  • Training development
  • Problem solving
  • Task prioritization

References

References available upon request.

Timeline

Claims Research & Resolution Representative 3

Humana
06.2021 - Current

Office Manager

Gayla's Tag Agency
08.2020 - 05.2021

Manager Trainee

The Chickasaw Nation
10.2017 - 05.2020

Training Coordinator

Tarrant County Tax Office
01.2011 - 10.2017

High School Diploma -

Newcastle High School

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