Sarah Weiks
Las Vegas
Summary
Operations Expert at Elevance Health with a proven track record in process improvement and data analysis. Skilled in project management and fraud investigation, I enhance team collaboration and communication. Successfully led initiatives that improved operational efficiency, showcasing my ability to drive results and foster positive relationships across departments.
Overview
6
6
years of professional experience
Work History
Operations Expert
Elevance Health
Las Vegas
03.2025 - Current
- Conducted thorough research on diverse coverage options to boost operational efficiency.
- Led process enhancements for special projects like IRT and COB Intake Project with Medicaid, ensuring precise coverage listings.
- Acted as interim leader during team functions, ensuring stability and smooth operations.
- Investigate and document fraud within the Marketplace Fraud initiative, facilitating fraud education, and monitoring progress.
- Filed grievances for members within NCC in Marketplace to enhance processing time and accuracy.
- Provided pilot and launch support for Fuse Launch project for GB-Medicaid.
- Contribute to the Q Greenbelt Project by researching NB coverage to support process improvement efforts.
- Utilize advanced Excel skills to manage and analyze complex data sets, creating pivot tables and charts to support decision-making processes.
- Enhance team communication and collaboration using tools like Spark, and develop/present effective presentations, such as town hall meetings.
- Collaborate extensively across various departmental functions and with other departments, showcasing multifaceted skills, and flexibility to contribute to successful operational outcomes.
ECOB Specialist II Special Ops (Tiger Team)
Elevance Health
Las Veg
08.2023 - 03.2024
- Demonstrated excellence in daily tasks as Level II specialist.
- Generated creative ideas for ideation site, aiding in process development and enhancement.
- Contributed to Dorothy pilot project, enhancing technical expertise.
- Demonstrated effective project management and organizational skills through GA special projects and inventory management.
- Generated SQL reports.
- Generated reports to track performance metrics of team members.
ECob Specialist
Elevance Health
Las Vegas
07.2021 - 08.2023
- Perform COB specialist tasks, focusing on OHI updates and participation in special projects.
- Served as subject matter expert in absence of team leaders, addressing team requirements.
- Guided new hires by providing shadowing opportunities.
- Coordinated with other departments to ensure efficient workflow processes.
- Reviewed documents for accuracy prior to submission or publication.
- Analyzed customer needs and recommended appropriate products or services.
- Identified needs of customers promptly and efficiently.
Provider Services Representative
Elevance Health
Las Vegas
12.2020 - 07.2021
- Assisted members with billing issues, reached out to providers, and processed claims.
- Handled claims discussions, remittance, and recoupment issues efficiently.
- Developed relationships with new providers by providing guidance on how to use our systems, processes, and policies.
- Followed up with clients on outstanding documents or payments required for processing claims or services rendered.
- Provided customer service to clients regarding their insurance coverage and billing inquiries.
- Adhered to all applicable laws, regulations, standards, and procedures when interacting with customers and providers.
- Assisted customers in navigating the online portal for self-service requests.
- Ensured compliance with HIPAA regulations while handling confidential patient information.
- Analyzed reports generated from the system to ensure timely submission of claims and accurate reimbursement amounts.
Customer Service Representative
Elevance Health
Las Vega
01.2020 - 11.2020
- Resolved customer complaints promptly and efficiently.
- Discussed member benefits, provider locations, and facilitated appointment setups.
- Managed appeals, grievances, and demographic updates; distributed correspondence, such as letters and ID cards.
- Resolved complex problems by working with other departments to provide solutions that meet customer needs.
- Conducted regular follow-up calls with customers after resolving their issues.
- Developed positive relationships with customers through friendly interactions.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
Skills
- Data analysis
- Process improvement
- Project management
- SQL reporting
- Fraud investigation
- Customer relationship management
- Effective communication
- Team collaboration
- Presentation development
- Research and analysis
- Problem solving
- Scheduling and planning
- Process improvements
- Team leadership
Timeline
Operations Expert
Elevance Health
03.2025 - Current
ECOB Specialist II Special Ops (Tiger Team)
Elevance Health
08.2023 - 03.2024
ECob Specialist
Elevance Health
07.2021 - 08.2023
Provider Services Representative
Elevance Health
12.2020 - 07.2021
Customer Service Representative
Elevance Health
01.2020 - 11.2020
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