Susan Craig
Provider Data Analyst
Champaign,IL
Summary
Enthusiastic and dedicated employee with integrity, strong work ethic and a passion for Big Data. Experienced with 25 years of working in the health insurance field. Motivated and results-driven in resolving problems and improving customer satisfaction. Strong organizational skills, work well independently and as a team member to achieve company goals. Skilled in working under pressure and adapting to new situations and challenges.
Overview
36
36
years of professional experience
Work History
Provider Data Analyst- Work From Home
Health Alliance Medical Plans
Champaign , Illinois
2020.04 - Current
- Update demographics for Health Providers in AS400 system used by organization.
- Work reports from Lexis Nexis to ensure correct data in AS400.
- Auditing and editing functions to obtain accurate provider data by contacting providers directly and accessing variety of websites and other sources.
- Usage of Excel and Sales Force.
- Run SAP and ACES reports.
- Research and resolve issues regarding integrity of data flow into databases.
Claims Analyst- Work From Home
Health Alliance Medical Plans
Champaign , Illinois
2005.11 - 2020.04
- Maintain knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations
- Follow strict confidentiality with all personal data as per company guidelines
- Processed claims with accuracy within 15 day turnaround
- Maintained strict confidentiality with all personal data as per company guidelines.
- Viewed reports regularly to make sure processing was conducted efficiently.
Electronic Medical Record Specialist
Carle Hospital And Clinics
Urbana , Illinois
2005.02 - 2005.11
- Managed patient medical charts and documented information into EPIC for hospital and clinics
- Maintained accuracy and met goals for each department
- Established pleasant relationships with staff
Claims Analyst- Work From Home
Stratum Med, Inc.
Urbana , Illinois
1999.08 - 2004.12
- Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations
- Maintained strict confidentiality with all personal data as per company guidelines
- Processed claims for third-party insurance company from Missouri with accuracy and turnaround time required
Prelog and Claims Processing
Health Alliance Medical Plans
Champaign , Illinois
1997.05 - 1999.08
- Researched paper insurance claims to provide member information for claims processing
- Processed claims accurately according to provider contracts
- Assuring turnaround times for processed claims
Case Manager
Developmental Disabilities Service Organization
Champaign , Illinois
1994.04 - 1997.04
- Developed appropriate care plans for clients in a group home setting
- Reviewed and recorded progress of clients with learning skills of daily activities
- Coordinated support services and optimized communication between healthcare workers and patients
Telesales Representative and Customer Service
Colwell Systems, Inc
Champaign , Illinois
1991.12 - 1994.04
- Received in-coming calls from doctors, dentists, chiropractors, optometrists, lawyers. and businesses
- Assisted in placing orders for wide variety of health care and business forms, business cards, and supplies
- Resolved problems with positive resolutions
Sales Clerk-Management
Payless ShoeSource
Champaign , Illinois
1985.11 - 1991.12
- Worked way from salesclerk to manager
- Responsible for interviewing, hiring, and training new employees
- Related daily and monthly reports to corporate office
- Responsible for upkeep of store and outside grounds
- Assisted with openings of three new stores
- Stocked shelves, processed new shipments
- Provided customer service
- Reported thefts
Education
Some College (No Degree) - Psychology And Art/ General Office Studies
Parkland College
Champaign, ILHigh School Diploma -
Centennial High School
Champaign Ill1984
Skills
- Positive outlook
- Teamwork/Collaboration
- Data Integrity Validation
- Customer Communication
- Spreadsheet Development
- Attention to Detail
- Resourceful Researching
- Independence and Initiative
- Work Organizing and Prioritizing
- Adaptability and Flexibility
Hobbies: drawing, painting, upcycling-making something new out of something old.
Created themes for six "Cat Condo's" for my Veterinarian's Practice. Painted each room with the theme. Built wall ramps for the cats to get from wall to wall. Added upcycled items to complete each "condo."
Have drawn/ painted pictures for friends and family.
Made usable lamp from an old oil can, colander, and other parts.
Presently, learning how to make things with Resin. Trying Acrylic paint pouring, as well as many other new ways to create something.
Timeline
Provider Data Analyst- Work From Home
Health Alliance Medical Plans
2020.04 - Current
Claims Analyst- Work From Home
Health Alliance Medical Plans
2005.11 - 2020.04
Electronic Medical Record Specialist
Carle Hospital And Clinics
2005.02 - 2005.11
Claims Analyst- Work From Home
Stratum Med, Inc.
1999.08 - 2004.12
Prelog and Claims Processing
Health Alliance Medical Plans
1997.05 - 1999.08
Case Manager
Developmental Disabilities Service Organization
1994.04 - 1997.04
Telesales Representative and Customer Service
Colwell Systems, Inc
1991.12 - 1994.04
Sales Clerk-Management
Payless ShoeSource
1985.11 - 1991.12
Some College (No Degree) - Psychology And Art/ General Office Studies
Parkland College
High School Diploma -
Centennial High School
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