Yolanda McCauley - Floyd
Blythewood,SC
Summary
Experienced with leading claims teams and managing complex claim processes. Utilizes effective communication and problem-solving skills to resolve issues promptly. Track record of fostering team collaboration and maintaining high operational standards.
Overview
25
25
years of professional experience
Work History
Claims Team Leader
Medcost Benefit Services
Winston-Salem, NC
06.2022 - Current
- Led claims processing team, ensuring adherence to company policies and regulatory plan requirements. Mentored and trained staff on best practices for claims management and dispute resolution strategies.
- Facilitated training sessions on new systems and procedures, improving team performance, and knowledge retention.
- Analyzed claim data to identify trends, improving accuracy in processing and reducing errors.
- Established a positive work environment through effective communication and teamwork.
- Communicated with staff, leaders and peers to coordinate successful collaboration with other departments.
- Accomplished multiple tasks within established timeframes.
Senior Claims Analyst
Medcost Benefit Services
Winston-Salem, NC
02.2009 - 06.2022
- Analyzed complex claims to ensure compliance with regulatory standards and company policies.
- Developed and implemented process improvements to enhance claims processing efficiency and accuracy.
- Trained and mentored analysts on best practices in claims evaluation and resolution strategies.
- Collaborated with cross-functional teams to resolve high-value claims, ensuring optimal outcomes for clients.
Claims Analyst
Medcost
Winston-Salem, NC
06.2001 - 02.2009
- Analyzed insurance claims to ensure compliance with policies and regulations.
- Demonstrated a high level of accuracy and attention to detail in reviewing claim documentation for approval or denial decisions.
- Participated in ongoing training programs to stay current on industry developments and maintain a strong understanding of relevant laws and regulations affecting the claims process.
Education
Bachelor of Science - Marketing
North Carolina A&T State University
Greensboro, NC05-1993
Skills
- Claims management expertise
- Strategic Decision-making
- MS office
- Verbal and written communication
Timeline
Claims Team Leader
Medcost Benefit Services
06.2022 - Current
Senior Claims Analyst
Medcost Benefit Services
02.2009 - 06.2022
Claims Analyst
Medcost
06.2001 - 02.2009
Bachelor of Science - Marketing
North Carolina A&T State University