Sabrina Harrell
Tampa,FL
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
16
16
years of professional experience
Work History
Commercial Product Analyst
Centene
03.2021 - Current
- Identify and analyze user requirements, procedures, and problems to improve existing processes.
- Attended weekly development team meetings and assisted in identification and resolution of issues to maintain timeline.
- Devised data visualization dashboards to make complex data more accessible to stakeholders.
- Perform detailed analysis on assigned projects, recommend potential business solutions and assist with implementations.
- Use Excel and Visio to complete daily tasks.
- Lead problem solving and coordination efforts between various business units.
- Identified ways to enhance performance management and operational reports related to new business implementation processes.
- Develop and incorporate organizational best practices into business applications.
- Assist with formulating and updating departmental policies and procedures
Business Analyst II
WellCare Health Plans Inc.
01.2019 - 03.2021
- Implemented business intelligence solutions to increase operational efficiency.
- Provided technical support for troubleshooting analytics and reporting issues.
- Generated ad-hoc reports to evaluate specific business requirements.
- Implemented best-practice methodologies that improved overall project delivery timelines while maintaining quality standards.
- Identify and analyze user requirements, procedures, and problems to improve existing processes.
- Lead problem solving and coordination efforts between various business units.
- Creating a detailed business analysis, outlining problems, opportunities and solution for a business
Operations Lead
WellCare Health Plans Inc.
04.2016 - 03.2021
- Maintained database systems to track and analyze operational data.
- Oversaw supply chain management, maintaining optimal inventory levels while minimizing procurement costs.
- Conducted regular performance assessments, providing constructive feedback and identifying areas for growth and development among team members.
- Frequently inspected production area to verify proper equipment operation.
- Partners with departmental management staff to maintain daily inventory standards while still surpassing applicable production goals.
- Conducted analysis of progress and held monthly meetings regarding goals and tasks.
- Monitored progress within each department toward goal attainment utilizing measurable data in spreadsheet applications.
- Assists with escalated issues in which require additional research in order to identify root cause.
CLAIMS SPECIALIST III
WellCare Health Plans Inc.
05.2015 - 04.2016
- Modified, updated and processed existing policies.
- Delivered comprehensive training sessions for new hires on claims handling procedures, policy interpretation basics, negotiation techniques, and other core competencies related to the role of a Claims Specialist.
- Provided advice to customers regarding claims, rights and insurance processes to prevent disputes.
- Maintain production, quality standards, and resolves institution and professional claims by approving and denying documentation; calculation of payments due based on state and benefit guidelines.
- Provides as a subject matter expertise to department projects by analyzing and performing root cause analysis on all types of claim issues and adjustments.
CLAIMS SPECIALIST II
WellCare Health Plans Inc.
03.2014 - 05.2015
- Acts as a mentor to associates by providing applicable up-trainings, reviewing associate quality feedback, and assisting with mitigation planning to ensure higher quality standards are met.
- Partners with departmental management staff to maintain daily inventory standards while still surpassing applicable production goals (126% average ).
- Demonstrates expertise with all assigned Line of Business. " Assists with escalated issues in which require additional research in order to identify root cause.
CLAIMS CONTENT SPECIALIST
Humana
01.2009 - 03.2014
- Research and make benefit determination for the processing of Medicare & Medicaid member claims according to processing guidelines.
- Maintain production, quality standards, and resolves medical claims by approving or denying documentation; calculating benefit due; initiating payment or composing denial letter.
- Establishes proof of loss by studying medical documentation; assembling additional information as required from outside sources, including claimant, physician, employer, hospital, and other insurance companies; initiating or conducting investigation of questionable claims.
CUSTOMER CARE SPECIALIST
Humana
02.2008 - 01.2009
- Responded proactively and positively to rapid change.
- Verified accuracy of customer account information and updated when necessary.
- Assisted call-in customers with questions and orders.
- Maintained up-to-date knowledge of product and service changes.
- Build lasting relationships with Humana’s customers and contact customers to respond to inquiries or to notify them of claim investigation results and any planned adjustments.
Education
High School Diploma -
Tampa Bay Technical High School
Tampa, FL06.1996
Skills
- Claims Adjusting
- Claims Auditing
- Microsoft Office
- Computer Proficiency
- Analytical Thinking
- Competitive Analysis
- Tableau Expertise
- Team Collaboration
- Team Leadership
- Customer Service
- Decision-Making
- Data Analytics
Timeline
Commercial Product Analyst
Centene
03.2021 - Current
Business Analyst II
WellCare Health Plans Inc.
01.2019 - 03.2021
Operations Lead
WellCare Health Plans Inc.
04.2016 - 03.2021
CLAIMS SPECIALIST III
WellCare Health Plans Inc.
05.2015 - 04.2016
CLAIMS SPECIALIST II
WellCare Health Plans Inc.
03.2014 - 05.2015
CLAIMS CONTENT SPECIALIST
Humana
01.2009 - 03.2014
CUSTOMER CARE SPECIALIST
Humana
02.2008 - 01.2009
High School Diploma -
Tampa Bay Technical High School
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