PHYLLIS C. GRAB
Bristol,CT
Summary
Results-driven individual with a solid track record in delivering quality work. Known for excellent communication and teamwork abilities, with a commitment to achieving company goals and delivering exceptional service. Demonstrated strengths include critical thinking, prioritizing and an ability to work independently and as a team player.
Overview
33
33
years of professional experience
Work History
Complex Claim Analyst
Cigna
Bristol, Connecticut
03.2008 - Current
- To ensure all U.S. claims are accurately and consistently reimbursed in accordance with industry-standard billing compliance guidelines.
- Primary lead contact person for the power system and claims within the complex claims unit.
- Perform research, data entry, processing, and adjusting of healthcare claims using a variety of healthcare-related systems.
- Examine claims and calculate reimbursement based on contract terms to determine the accuracy of payment, along with supporting documentation.
- Team player and assists with questions that arise on the team.
Claim Processor Senior Associate
Cigna
Bristol, Connecticut
02.1994 - 02.2008
- Continuously achieves national standards for both quality and production, while being flexible to support all of the office incentives.
- Learned to utilize multiple claim-paying systems to process, adjust, and adjudicate medical claims.
- Identifies and analyzes problems, takes action to resolve them, applies sound judgment, and takes ownership for their resolution.
- Takes time to identify and meet internal and external customer expectations. Makes decisions, prioritizes, and carries out daily responsibilities.
- Utilized all available resources to ensure the translation of correct information.
Benefit Analyst/Support Specialist
PALICO
Farmington, Connecticut
01.1992 - 01.1994
- Accurately processed medical claims while lending support and knowledge to other parts of the office that needed help or assistance.
- Responsible for meeting, maintaining, and exceeding both quality and production standards.
- Acted as a resource to the current supervisor and team members by assisting with questions when needed.
- Supported the customer service area when call volume was high, and demonstrated accurate knowledge of contracts and current office procedures during telephone communications to promote good customer relations.
- Demonstrated good listening skills to effectively respond to customers and/or providers with complex service issues.
Skills
- Verbal and written communication
- Team collaboration and leadership
- Continuous improvement
- Multiple priorities management
- Data research and validation
- Time management
Timeline
Complex Claim Analyst
Cigna
03.2008 - Current
Claim Processor Senior Associate
Cigna
02.1994 - 02.2008
Benefit Analyst/Support Specialist
PALICO
01.1992 - 01.1994
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