Taylor McNaughton
Monroe,LA
Summary
Goal-oriented, Self-sufficient, Positive, Cheerful, People-oriented, Detail-oriented, Excellent time management skills. Associate Business Analyst, offering 6 years of wide-ranging expertise. Knowledgeable and practiced in claims processing. Skilled in workflow management, communication, organization and task prioritization.
Overview
11
11
years of professional experience
Work History
Associate Business Analyst
Blue Cross And Blue Shield Of Louisiana
12.2023 - Current
- Streamlined operational efficiency by identifying areas of improvement and implementing effective solutions.
- Assisted in the development of strategic plans, incorporating valuable input from various departments within the organization.
- Actively contributed to the ongoing success of team members by sharing knowledge, insights, and best practices during regular meetings and collaborative working sessions.
- Organized daily tasks for better efficiency and use of resources.
- Developed customized reports, summarizing and presenting data in visually appealing format.
- Identified patterns and trends in large data sets and provided actionable insights.
- Generated standard and custom reports to provide insights into business performance.
- Increased accuracy in claims data entry, ensuring proper documentation for future reference and audits.
- Collaborated with team members to develop strategies for optimizing the claims process, resulting in improved client experience.
- Maintained up-to-date knowledge of industry regulations, keeping compliant with state requirements while processing claims.
- Managed high-volume caseloads, prioritizing tasks effectively to ensure timely resolution of all assigned claims.
- Assisted in the development of training materials for new Claims Examiners, fostering a supportive learning environment.
Institutional Medicare Claims Coordinator
Vantage Health Plan, Inc.
01.2020 - 12.2023
- Managed large volume of medical claims on a daily basis.
- Paid or denied medical claims based upon established claims processing criteria.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
- Audited claims to ensure accuracy
- Trained employees per regulations and guidelines provided by Vantage Health Plan
- Assisted other departments in claims processing
- Provide answers to examiners and other departments in order for claims to be processed accurately claims processing efficiency by streamlining workflows and implementing organizational systems.
- Increased accuracy in claims data entry, ensuring proper documentation for future reference and audits.
- Collaborated with team members to develop strategies for optimizing the claims process, resulting in improved client experience.
- Maintained up-to-date knowledge of industry regulations, keeping compliant with state requirements while processing claims.
- Managed high-volume caseloads, prioritizing tasks effectively to ensure timely resolution of all assigned claims.
- Conducted detailed investigations into complex claims cases, gathering necessary information to reach accurate conclusions and determine appropriate actions.
- Efficiently navigated company databases to retrieve essential information for accurate claim handling and reporting purposes.
- Assisted in training new hires on company policies and procedures related to the Claims Coordinator role, ensuring a seamless transition into their positions.
- Monitored pending claims closely to identify potential issues or delays in processing promptly addressing them before escalation occurred.
- Contributed to departmental meetings by sharing insights gained from daily work experiences which helped improve overall team performance.
- Liaised between various departments within the organization to facilitate efficient communication flow during claims management processes.
- Implemented new software tools that streamlined administrative tasks associated with managing multiple claim files simultaneously.
Institutional Medicare Claims Examiner
Vantage Health Plan, Inc.
07.2017 - 12.2019
- Paid or denied claims based upon established claims processing criteria.
- Used administrative guidelines as a resource or to answer questions when processing medical claims.
- Maintained knowledge of claims processing, claims principles, medical terminology and procedures and HIPPA regulations.
- Audited claims to ensure accuracy.
- Assisted other departments in claims processing
Teller
Tensas State Bank
11.2013 - 07.2017
- Executed customer transactions, including deposits, withdrawals, money orders and checks.
- Scheduled staffing for main branch.
- Rapidly and efficiently prepared customer and ATM cash and change orders.
- Handled various accounting transactions.
- Created member account profiles on Tensas State Bank online banking program.
- Collected member loan payments.
- Sold cashier's checks, traveler's checks and money orders.
- Executed stop payments and account transfers Answered telephone inquiries on banking products including checking, savings, loans and lines of credit.
- Maintained friendly and professional customer interactions.
Education
No Degree - Medical Billing And Coding
Penn Foster Career School
Scranton, PA12.2024
High School Diploma -
Newellton Christian School
Newellton, La05.2012
Skills
- Attention to Detail and Organization
- Sorting and Filing
- Verbal and Written Communication
- Information Processing
- Time management
- Adaptability
- Computer literacy
- Microsoft Certified
- Pivot tables
- Microsoft Office
- Teamwork and Collaboration
- Self Motivation
- Analytical Skills and Thinking
Timeline
Associate Business Analyst
Blue Cross And Blue Shield Of Louisiana
12.2023 - Current
Institutional Medicare Claims Coordinator
Vantage Health Plan, Inc.
01.2020 - 12.2023
Institutional Medicare Claims Examiner
Vantage Health Plan, Inc.
07.2017 - 12.2019
Teller
Tensas State Bank
11.2013 - 07.2017
No Degree - Medical Billing And Coding
Penn Foster Career School
High School Diploma -
Newellton Christian School
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