Rachel Lynn Mansfield
St. Charles,MO
Summary
Dynamic Claims Analyst Supervisor at Administrative Strategies with expertise in claims processing and data analysis. Proven track record of enhancing operational efficiency and compliance through comprehensive documentation management. Adept at fostering teamwork and driving performance improvements, while maintaining strong customer relationships and regulatory adherence.
Overview
20
20
years of professional experience
Work History
Claims Analyst Supervisor
Administrative Strategies
06.2021 - Current
- Trained and mentored new staff on best practices for claims handling and customer service
- Investigated, evaluated and adjusted multi-line claims in accordance with standards and laws
- Developed and maintained comprehensive documentation of claims processes for team reference and to ensure compliance with regulatory requirements.
- Fostered a positive work environment that promoted collaboration, teamwork, and open communication among staff members in order to reduce claim processing time by through efficient workflow
- Analyzed claim data to identify trends, driving proactive solutions and operational enhancements while monitoring performance metrics regularly, identifying areas for improvement and implementing corrective measures accordingly.
- Managed a diverse caseload, prioritizing tasks effectively to meet strict deadlines and maintain quality standards including supervision of claims processing team.
Claims Analyst
Administrative Strategies
11.2020 - Current
- Analyze gathered information and report findings to appropriate personnel
- Refer complex or questionable claims to supervisors for review
- Examine claims forms and medical records to determine insurance coverage
- Review documents for completeness, accuracy and compliance with policies
- Enter patient demographics, medical history, diagnoses and treatment information into the system.
- Clarify conflicting or incomplete medical records by consulting with veterinarians
- Compile, sort and verify accuracy of data prior to system entry
- Assist team members with questions regarding claims processing and coverage
- Maintain updated knowledge of insurance policies and refer to reference materials when needed
Customer Service Specialist
Driver Seat Auto Sales
St. Peter's, MO
09.2010 - 12.2020
- Run payroll for Dealership Employees Bi-weekly through ADP
- Create billing invoice for all customers, business to business contacts and Redline Auto Repair
- Handle inbound and outbound customer service calls, inquiries and appointments
- Manage banking, billing and parts accounts for dealership/auto repair
- Schedule, create and maintain all phone appointments for salesman, auto quote
- Manage dealership website maintenance, inquiries and emails
Assistant Manager/Inside Sales Consultant
Ideal Image
Jacksonville, USA
10.2017 - 01.2020
- Receive and following through with incoming calls and emails from first point of contact to close of the sale.
- Assist with various sales and marketing activities, cross train with other team members to become proficient at all levels of sales and service process.
- Initiate and/or assisting with any task, office duty, or project necessary to maintain a highly functioning, fast paced cosmetic medical office.
- Following up with previous potential guests to renew their interest through self-created innovative, impactful, and customized marketing campaigns.
- Interpersonal communication skills, ability to influence and negotiate, trust and rapport-building.
- Ability to articulate verbal and written communication in a compelling, creative and professional manner.
- Rapid learner with the ability to grasp concepts and protocols associated with sales processes and computer systems.
- Ability to work independently, strong sense of urgency, ability to work with poise under stressful, fast-paced conditions.
- Organized, multitasking, prioritizing, time management and follow up skills are detail oriented with a high level of accuracy.
- Computer Savvy - proficient with computers and contemporary software applications (Office Suite, Excel, Outlook etc), quick to master new software.
Patient Care Tech - Cardiovascular Unit
Mayo Clinic
Jacksonville, USA
07.2016 - 09.2017
- Accountable for the performance of patient care activities under the direction of a Registered Nurse for a designated group of patients in accordance with hospital policies and procedures
- Assists patients in all aspects of activities of daily living and in meeting mobility, elimination and nutritional needs
- Perform skills that are consistent with the plan of care and the needs and age of the patient
- Perform specialized care: pre- and post-operative care, respiratory care and post-mortem care
- Collaborates with the patient/significant others and members of the health care team to facilitate the plan of care established by the Registered Nurse
- Assists the Registered Nurse in the development of the care plan, educational plan and discharge plan related to age specific issues
- Participate in learning opportunities that promote skill development
- Adhere to hospital infection control policies, practices standard blood and body fluid precautions and uses protective equipment when indicated
- Preceptor for new hires/cross trained employees for the cardiac floor
- Follows hospital policies and procedures. Understands and Educated on HIPAA and patient confidentiality
Clinical Partner/Floor Tech
SSM DePaul Health Center
Bridgeton, Missouri
11.2005 - 07.2016
- Responsible for 39 acute adult patients, 12 geriatric patients, 8 developmentally disabled patients, and electro-convulsive therapy services (ECT)
- CPI certified and trained.
- CPR certified
- ACCU Check Certified
- Obtained and monitored daily vitals, blood draws, hygiene, and care plans on all patients.
- Worked Claims through internal systems for ECT patients
- Created, developed and coached daily coping skills classes for patients, i.e. abuse, addiction, sexual assault, etc
- Panel member for Behavioral Medicine at St. Vincent's Depaul for new hires, interviews and unit meetings
- Lead preceptor for new hires and/or trainees and nursing students doing during their clinical rounds
- Lead tech
Education
High School Graduate -
Francis Howell Central
5199 State Rte N, Cottleville, MO 6330401.2005
Continuing College Education - General Education
St. Charles Community College
St. CharlesSkills
- Claims processing
- Claim evaluation
- Data analysis
- Documentation management
- Regulatory compliance
- Customer relationship management
Additional Professional Activities And Certificates
- Mastered and educated employees with Smart-Square, a staffing and scheduling program.
- Certified Epic super-user; Educated and trained employees on electronic charting program.
- Non-Violent Crisis Prevention Intervention (CPI)
- Management of the Agitated Patient: From Control to Care
- Communicating with Borderline, Anti-Social Personality Disorder and other Difficult Clients: Letting go of the Struggle
- Mission and Leadership: Making Value Based Decisions
- Workplace Harassment
- Relationship Based Care
- Coaching and Development
- Motivation
- Conflict Management
- EPIC electronic health record 'Super User'
- CPR
References
References available upon request.
Timeline
Claims Analyst Supervisor
Administrative Strategies
06.2021 - Current
Claims Analyst
Administrative Strategies
11.2020 - Current
Assistant Manager/Inside Sales Consultant
Ideal Image
10.2017 - 01.2020
Patient Care Tech - Cardiovascular Unit
Mayo Clinic
07.2016 - 09.2017
Customer Service Specialist
Driver Seat Auto Sales
09.2010 - 12.2020
Clinical Partner/Floor Tech
SSM DePaul Health Center
11.2005 - 07.2016
High School Graduate -
Francis Howell Central
Continuing College Education - General Education
St. Charles Community College