Summary
Overview
Work History
Education
Skills
Timeline
Generic

Sabrina Harrell

Tampa,FL

Summary

Seasoned collaborator experienced in meeting needs, improving processes and exceeding requirements in team environments. Diligent worker with strong communication and task prioritization skills.

Overview

16
16
years of professional experience

Work History

Business Analyst II

Elevance Healthcare
05.2024 - Current
  • Actively participated in team meetings to share knowledge, exchange ideas, address challenges, and collaborate on potential solutions.
  • Analyzes business needs to determine optimal means of meeting those needs.
  • Performed gap analysis between existing systems or processes and desired state, identifying areas for improvement or enhancement.
  • Acts s liaison with users of the software to address questions/issues.

Customer Service Assistant Supervisor

ABM Building Value
05.2023 - 07.2024
  • Enhanced customer satisfaction by addressing and resolving complex issues in a timely manner.
  • Mentored junior staff, resulting in increased productivity and reduced turnover rates.
  • Responded to customer inquiries and resolved complaints to establish trust and increase satisfaction.
  • Conducted training and mentored team members to promote productivity and commitment to friendly service.
  • Coached employees through day-to-day work and complex problems.
  • Effectively allocated tasks during high-traffic times to keep operations running smoothly and employees focused.

Commercial Product Analyst

Centene
03.2021 - 05.2024
  • 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.
  • Serve as the subject matter expert on the assigned function product to ensure operational performance.
  • Lead the identification and analysis of user requirements, procedures, and problems to improve existing processes.
  • Assisted development leads in definition of process flows, relative task priorities and business value measurement parameters.
  • Collected and analyzed data from variety of sources to create detailed market research reports for top-level decision makers.
  • Utilized specialized software to capture and process data.

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.
  • Performed gap analysis between existing systems or processes and desired state, identifying areas for improvement or enhancement.
  • Supported software development projects by defining clear requirements and effectively communicating them to technical teams.
  • Analyzed data to identify root causes of problems and recommend corrective actions.

Operations Lead

WellCare Health Plans Inc.
04.2016 - 01.2019
  • Maintained database systems to track and analyze operational data.
  • 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.
  • Educated staff on organizational mission and goals to help employees achieve success.
  • Collaborated with cross-functional teams to achieve company-wide objectives and drive operational excellence.
  • Drove process improvement initiatives that led to increased efficiency and streamlined procedures across multiple departments.
  • Planned operations and activities, and led projects.
  • Conducted regular reviews of operations and identified areas for improvement.

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.
  • Achieved successful appeal outcomes by meticulously reviewing and analyzing claim denials, identifying errors, and presenting persuasive arguments.
  • Expedited resolution times for appeals cases by efficiently managing workload and prioritizing urgent matters.
  • Collaborated with cross-functional teams to gather necessary documentation and evidence to support the appeals process.
  • Enhanced overall department efficiency by developing and implementing standardized procedures for handling appeals cases.
  • Maintained high levels of accuracy in all written correspondence, ensuring clear communication with relevant stakeholders during the appeals process.
  • Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
  • Identified fraudulent claims through thorough investigation and documentation of findings.
  • Collaborated with cross-functional teams to resolve complex claims issues efficiently and effectively.
  • Trained new employees on claims processing procedures, contributing to a well-prepared workforce.
  • Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.

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
06.1996

Skills

  • Customer Communication
  • Data Analysis
  • Requirements Gathering
  • Microsoft Office Suite
  • Project Management
  • Workflow Analysis

Timeline

Business Analyst II

Elevance Healthcare
05.2024 - Current

Customer Service Assistant Supervisor

ABM Building Value
05.2023 - 07.2024

Commercial Product Analyst

Centene
03.2021 - 05.2024

Business Analyst II

WellCare Health Plans Inc.
01.2019 - 03.2021

Operations Lead

WellCare Health Plans Inc.
04.2016 - 01.2019

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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Sabrina Harrell