Nina Harrell
Albuquerque
Summary
Dynamic Senior Product Specialist at Cognizant Technology Solutions with a proven track record in enhancing claims auto adjudication by 25%. Adept at data-driven decision making and effective communication, I foster collaboration across teams, ensuring successful product launches and high customer satisfaction. Committed to mentoring and driving professional growth within my team.
Overview
17
17
years of professional experience
Work History
Senior Product Specialist - HPC-Config
Cognizant Technology Solutions, CTS
06.2024 - Current
- Customized products according to client benefits and CMS specifications.
- Maintained provider contracts, client benefits, and fee schedules as needed.
- Problem solved hard errors in claims processing system
- On Project team for two new client implementations as well as three system upgrades, and two NetworX implementations.
- Collaborated with different department teams to ensure seamless product launches during AEP and other client projects.
- Increased Claims Auto Adjudication from 65% to 90% by improving processes
- Mentored junior team members towards professional growth, fostering an environment conducive to knowledge sharing.
- Boosted customer satisfaction rates through timely resolution of concerns and regular follow-ups on feedback. Receiving a perfect 10 from client satisfaction review surveys.
- Experience in Facets, NetworX, Workflow, Excel, SQL and Word.
- Clients include Medicare, Full Dual, Partial Dual and Medicaid.
Configuration Analyst
Lovelace Health Plan
03.2011 - 05.2024
- Maintenance of systems including: Fee Schedules, client Benefits, Provider contracts, claims configuration
- Project team lead to transition member benefits plans to new health plan
- Lead the configuration training for on coming claims processors.
- Experience in the following application: Facets, NetworX, Workflow, SQL, Excel
- Clients included Medicare, Medicaid and Commercial
Customer Service Specialist
Lovelace Health Plan
08.2008 - 03.2011
- Handled escalated calls calmly, finding resolutions that satisfied both the company and the customer''s needs.
- Managed high call volume while maintaining a courteous and professional demeanor.
- Assisted new employees with training, sharing best practices for handling difficult situations and achieving positive outcomes.
- Adapted quickly to changes in company policies or procedures ensuring consistency in delivering accurate information to customers.
Education
Associate of Applied Science - Graphic Design
Central New Mexico Community College
Albuquerque, NM05-2004
Skills
- Data-driven decision making
- Customer needs assessment
- Regulatory compliance
- Product documentation
- Effective communication
- Teamwork and collaboration
- Verbal and written communication
- Relationship building
- Self motivation
- Time management abilities
Accomplishments
- Increased claim adjudication by 25%
- Achieved two successful clients implementations
- Achieved NetworX implementations for two clients converting from core Facets pricing.
- Achieved a 10 star customer service rating from client and acknowledged company wide.
Timeline
Senior Product Specialist - HPC-Config
Cognizant Technology Solutions, CTS
06.2024 - Current
Configuration Analyst
Lovelace Health Plan
03.2011 - 05.2024
Customer Service Specialist
Lovelace Health Plan
08.2008 - 03.2011
Associate of Applied Science - Graphic Design
Central New Mexico Community College
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