Octavia Dawkins
Kings Mountain,NC
Summary
Professional in the field of accounting, financial analysis, reporting, and compliance. Known ability to improve processes and maintain accurate financial records. Reliable team collaborator with focus on achieving results and adaptability to changing needs. Proficient in financial management and regulatory compliance. Experienced with reconciliation, and compliance. Utilizes advanced analytical skills to ensure accuracy and efficiency in financial processes. Strong understanding of regulatory standards and ability to adapt to evolving financial environments.
Overview
9
9
years of professional experience
Work History
Client Advocate
Aetna
Gastonia, NC
01.2020 - Current
- Demonstrated excellent listening, verbal, and written communication skills in all interactions with customers.
- Facilitated dispute resolution processes for mishandled claims.
- Identified trends in customer complaints and developed strategies to address them proactively.
- Utilized strong organizational abilities to prioritize tasks and manage multiple projects simultaneously.
- Created detailed reports on customer feedback data for review by senior management.
- Utilizes Medical Directors and other Aetna personnel to clarify medical necessity and billing appropriateness.
SIU Analyst
Aetna
Gastonia, NC
01.2019 - 01.2020
- Reviews pre-specified claims for potentially fraudulent activity, and returns them to the claims operation sites for proper adjudication.
- Utilizes medical directors and other Aetna personnel to clarify medical necessity and billing appropriateness.
- Handles telephone and written inquiries from the providers, members, plan sponsors, law enforcement agencies, etc.
- Conducted data analysis to identify trends and insights.
Claims Benefit Specialist
Aetna
Gastonia, NC
04.2016 - 01.2019
- Analyzes and approves routine claims that cannot be auto-adjudicated.
- Applies medical necessity guidelines to determine coverage, complete eligibility verification, identify discrepancies, and apply all cost containment measures to assist in the claim adjudication process.
Education
Associate Degree - Accounting
Strayer University
06.2024
High School Diploma - US
Harding University High School
01.1997
Skills
- Data Entry
- Critical Thinking
- Analytical Skills
- Problem Solving
- Attention to Detail
- Oral and Written Communication Skills
Accomplishments
- Superior Contributor Award
- Most Outstanding Customer Service Representative
Timeline
Client Advocate
Aetna
01.2020 - Current
SIU Analyst
Aetna
01.2019 - 01.2020
Claims Benefit Specialist
Aetna
04.2016 - 01.2019
High School Diploma - US
Harding University High School
Associate Degree - Accounting
Strayer University