Whitney Wharton
Casper,Wyoming
Summary
Proven Claims Analyst with a track record of processing and investigating claims efficiently for the State of Wyoming - Workers' Compensation. Leveraged expertise in claims analysis and interpersonal communication to enhance decision-making and customer service. Recognized by customers at all levels for excellence in addressing basic questions and complex problems. Utilized extensive knowledge of medical and pharmacy as related to individual claims. Leader and mentor to new staff members.
Overview
29
29
years of professional experience
Work History
Claims Analyst
State of Wyoming - Workers' Compensation
09.2001 - 10.2024
- Received and processed new injury claims.
- Conducted thorough investigations into each claim, gathering relevant data and documentation to support decision-making processes.
- Managed high-volume caseloads, prioritizing tasks to ensure timely completion of all claims.
- Provided exceptional customer service by promptly addressing inquiries from policyholders, agents, and other stakeholders and ensuring resolution.
- Demonstrated a high level of accuracy and attention to detail in reviewing claim documentation for approval or denial decisions.
- Utilized exceptional communication skills - both written and verbal - to convey information to customers at every level.
- Utilized - and grew - knowledge of pharmacy, common industrial diagnoses, medical terminology, and coding to efficiently provide timely and accurate payments.
- Appropriately and compassionately administered the requirements of the law governing the workers' compensation program.
Executive Director
Wyoming Fair Housing
09.2000 - 05.2001
- Established the first Fair Housing program in Wyoming
- Traveled the state to educate the public about Fair Housing laws and the new program.
- Accepted and supervised the investigation of complaints and prepared formal referrals to HUD upon findings of substantiation.
- Recognized as a Best Practices recipient by HUD within the first six months of the program's existence.
Social Worker/Program Director
Mother Seton Housing
09.1995 - 09.2000
- Updated client documentation for accurate, compliant and current records.
- Interviewed clients, families, or groups to assess situations, limitations and issues and implement services to address needs.
- Collaborated with multidisciplinary teams to ensure appropriate care coordination and resource allocation for clients.
- Educated families on available community resources, connecting them with essential services such as housing assistance, financial aid, or healthcare providers.
- Supported clients and families with empathy and compassion during difficult times.
- De-escalated stressful situations through individual and family crisis interventions.
- Assisted with fundraising campaigns.
Education
Bachelor of Arts - Social Work, Pharmacy
University of Wyoming
Laramie, WY & Casper, WY05.1990
Skills
- Claims
- Claims analysis
- Interpersonal and written communication
- Policy Interpretation
- Data Interpretation
- Document workflow
- Claim investigation
- Teamwork
Additional Information
References available upon request.
Timeline
Claims Analyst
State of Wyoming - Workers' Compensation
09.2001 - 10.2024
Executive Director
Wyoming Fair Housing
09.2000 - 05.2001
Social Worker/Program Director
Mother Seton Housing
09.1995 - 09.2000
Bachelor of Arts - Social Work, Pharmacy
University of Wyoming
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