Summary

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Jan. 1984-Present Aetna US Healthcare, Allentown, PA 18195

June 96: Account Specialist

Responsibilities include: Assisting division manager with supervision of a claim processing unit, which includes monitoring employee performance and conducting unit meetings. Divisional support in assisting major policyholders in processing of their group medical, dental, managed care, and spending account claims for their employees and joining sales managers in marketing team promotions. Responsibilities also include: answering insurance department complaints, complex file reviews, and conducting employee meetings for our policyholders.

April 92: Supervisor, Claim Processing and Customer Service Unit

Responsibilities include: Supervising a claim processing unit consisting of an assistant supervisor, claims processors, member service representatives, and a unit clerk. Position is responsible for serving major policyholders with the processing of their group medical, dental, managed care, and spending account claims for their employees, joining sales representatives in marketing team promotions, and serving on committees.

October 90: Assistant Supervisor/Trainer

Responsibilities include: Supervising and counseling new employees for their first five to six months of professional experience. This consists mainly of training new employees on a computer system for processing medical and dental insurance.

August 89: Medical Management Analyst

Responsibilities include: Review referred claims for medical necessity, prevailing fee and reimbursement level. Conducted provider and health facility surveys and fraud investigation.

January 84: Customer Service Representative/Claims Processor

Responsibilities include: Process Medical/Dental/Disability claims and adjusting claims based on telephone and written inquiries.

EDUCATION:

PERSONAL: