Sarah Sichting
Winchester,IL
Summary
Results-driven Grievance & Appeals Analyst with a strong track record in managing high-volume cases while ensuring compliance and accuracy. Skilled in streamlining processes and promoting teamwork to improve operational efficiency and customer satisfaction.
Overview
11
11
years of professional experience
Work History
Grievance & Appeals Analyst
LIBERTY Dental Plan
Remote
11.2024 - 04.2026
- Analyzed appeal cases to determine eligibility for coverage under dental benefit plans.
- Collaborated with cross-functional teams to streamline the appeals process and improve turnaround times.
- Reviewed documentation and verified compliance with regulatory requirements for claims processing.
- Developed training materials to educate staff on best practices in appeals handling and resolution.
- Implemented tracking systems for monitoring appeal statuses, enhancing reporting accuracy and efficiency.
- Maintained detailed records and organized documentation to facilitate smooth appeals processing, ensuring all relevant information was readily available for review.
- Enhanced customer satisfaction with timely resolution of appeals, addressing concerns thoroughly and professionally.
- Managed a high volume of cases, prioritizing tasks effectively and meeting strict deadlines for appeals resolutions.
Customer Care Advocate
Prudential
Remote
10.2021 - 11.2024
- Resolved customer inquiries through effective communication and problem-solving techniques.
- Streamlined complaint resolution processes, improving response times and customer satisfaction rates.
- Maintained detailed records of each interaction, ensuring accurate documentation for future reference or follow-up purposes.
- Maintained compliance with regulatory requirements by staying current on industry standards and guidelines.
- Displayed excellent time management skills while managing multiple high-priority cases concurrently without compromising quality or attention to detail.
- Promoted a culture of continuous learning and development within the Grievance Appeals team, encouraging skill growth and knowledge sharing.
- Conducted thorough investigations for complex cases, ensuring fair and accurate outcomes.
- Coordinated with senior specialist to compose appeal responses.
- Maintained confidentiality of patient finances, records, and health statuses.
Claims Technician
Blue Cross and Blue Shield
Jacksonville, IL
08.2017 - 10.2020
- Processed claims efficiently, ensuring adherence to regulatory guidelines and organizational policies.
- Analyzed claim documentation for accuracy, identifying discrepancies and initiating resolution procedures.
- Maintained accurate records of all claims processed, ensuring compliance with company policies and industry regulations.
- Collaborated with team members to improve communication, resulting in a more productive work environment.
- Enhanced customer satisfaction by promptly addressing and resolving claims issues.
- Managed high volume of daily claims while maintaining attention to detail and superior customer service standards.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
CNA
Liberty Village
Pittsfield, IL
08.2015 - 03.2016
- Assisted with daily living activities, promoting independence among residents.
- Monitored vital signs and reported changes to nursing staff promptly.
- Maintained accurate patient records, enhancing communication within healthcare teams.
- Promoted good oral and personal hygiene by aiding patients with shaving, bathing, and teeth brushing.
- Answered call lights and supported patient comfort and safety by adjusting bed rails and equipment.
- Ensured prompt response to call lights, addressing patient needs in a timely manner.
- Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
- Provided emotional support for patients during challenging times, fostering a positive healing environment.
- Cared for residents in assisted living facility and delivered high-quality support to meet needs.
Education
Medical Assistant - Healthcare
Midwest Technical Institute
Springfield, IL05-2009
High School Diploma -
Westfair Christian Academy
Jacksonville05-2008
Skills
- Teamwork and collaboration
- Problem-solving
- Insurance policy knowledge
- Time management
- Attention to detail
- Multitasking
- Claims investigation
- Claims
- Workload prioritization
- Claims evaluation
- Computer literacy
Timeline
Grievance & Appeals Analyst
LIBERTY Dental Plan
11.2024 - 04.2026
Customer Care Advocate
Prudential
10.2021 - 11.2024
Claims Technician
Blue Cross and Blue Shield
08.2017 - 10.2020
CNA
Liberty Village
08.2015 - 03.2016
Medical Assistant - Healthcare
Midwest Technical Institute
High School Diploma -
Westfair Christian Academy