Crystal Holt
Indianapolis
Summary
Dynamic Claims Business Process Analyst with a proven track record at UnitedHealthcare, excelling in process improvement and team collaboration. Leveraged effective communication to mentor junior staff and streamline workflows, enhancing productivity by 30%. Skilled in change management and technical interactions, driving strategic initiatives that align with organizational goals.
Overview
20
20
years of professional experience
Work History
Claims Business Process Analyst
UnitedHealthcare
Indianapolis, IN
04.2022 - Current
- Assisted in analyzing business processes to identify areas for improvement.
- Served as a subject matter expert on business process analysis methodologies within the organization, mentoring junior team members as needed.
- Supported documentation of process workflows and standard operating procedures.
- Assisted in developing departmental strategies for process improvement, aligning initiatives with overall organizational goals.
- Conduct training sessions to improve understanding of business methodologies.
- Streamlined business processes by analyzing and identifying areas for improvement, reducing inefficiencies and boosting productivity.
- Collaborated with upper management to drive strategy and implement new processes.
- Collaborated with cross-functional teams to develop optimized business processes, resulting in improved collaboration and communication.
- Provided ongoing support to team members during transition periods following process updates, minimizing disruption and maintaining productivity levels.
FC Associate Part Time
Amazon
Plainfield, IN
06.2024 - Current
- Coordinated daily workflow to ensure timely order fulfillment and customer satisfaction.
- Collaborated effectively with team members for seamless coordination during high-volume periods, ensuring timely order completion.
- Assisted in training new hires on company procedures, fostering a supportive learning atmosphere that helped improve productivity levels.
- Utilized material handling equipment responsibly, reducing workplace accidents and maintaining an organized warehouse layout conducive to efficient operations.
- Followed procedures at all times for personal and team safety.
- Operated material handling equipment to ensure safe and efficient movement of inventory.
- Managed order picking processes to enhance accuracy and reduce fulfillment errors.
- Prepared packages for shipment while adhering to carrier guidelines, resulting in reduced damages and returns due to improper packaging.
- Expedited order processing time with proficient use of warehouse management software and scanning equipment.
- Adapted quickly to shifting priorities during peak seasons or promotional events, ensuring prompt fulfillment of all orders without compromising on accuracy or quality standards.
Senior Appeals Representative
UnitedHealthcare
Indianapolis, IN
07.2019 - 04.2022
- Resolved complex appeals by analyzing case details and ensuring compliance with regulatory guidelines.
- Collaborated with cross-functional teams to streamline appeal processes and enhance service delivery.
- Investigated discrepancies in underwriting, providing accurate information for timely resolution of customer inquiries.
- Implemented process improvements that reduced response times for appeals, increasing overall efficiency.
- Educated clients on the appeals process, enhancing understanding and satisfaction with services provided.
- Mentored junior representatives on best practices in handling appeals and client interactions effectively.
- Conducted training sessions on updated policies and procedures to ensure team compliance and accuracy in operations.
- Provided excellent customer service by actively listening to customer concerns and empathetically addressing their needs throughout the appeals process.
- Maintained detailed records of appeal outcomes, facilitating improved tracking and reporting systems.
Senior Claims Auditor
International Medical Group
Indianapolis, IN
10.2018 - 07.2019
- Conducted thorough audits of claims for compliance with company policies and regulatory standards.
- Evaluated claims documentation to ensure accuracy and completeness, reducing discrepancies.
- Collaborated with cross-functional teams to identify process improvements and streamline operations.
- Provided training and mentorship to junior auditors, enhancing team performance and knowledge sharing.
Global Underwriter
International Medical Group
Indianapolis, IN
04.2013 - 10.2018
- Evaluated risk factors to determine underwriting decisions for various insurance policies.
- Collaborated with brokers to assess client needs and provide tailored insurance solutions.
- Reviewed claims history to identify trends, informing strategic adjustments in underwriting criteria.
- Documented underwriting decisions and provided evidence of compliance with applicable regulations.
- Provided excellent customer service by addressing inquiries promptly and offering comprehensive explanations of underwriting decisions.
- Made approval and denial recommendations by determining accurate risk levels.
- Developed and implemented underwriting guidelines to enhance efficiency and consistency in decision-making.
Medical Underwriter
Tokio Marine HCC
Indianapolis, IN
05.2005 - 04.2013
- Evaluated medical records to determine risk factors and coverage eligibility.
- Analyzed underwriting guidelines to ensure compliance with industry standards.
- Led initiatives to streamline the underwriting process, enhancing efficiency and accuracy.
- Implemented quality control measures to minimize errors in underwriting documentation.
- Streamlined underwriting processes for faster decision-making through the implementation of automated tools.
- Developed training materials for new underwriters, improving overall team performance and understanding of complex medical issues.
- Ensured timely claim processing by effectively prioritizing caseloads based on complexity and urgency levels.
- Developed comprehensive reports summarizing underwriting decisions for internal review.
Education
No Degree -
Indiana University
INHigh School Diploma -
Lawrence Central High School
Indianapolis, IN06-1994
Skills
- Technical team interactions
- Team collaboration
- Effective communication
- Process change management
Timeline
FC Associate Part Time
Amazon
06.2024 - Current
Claims Business Process Analyst
UnitedHealthcare
04.2022 - Current
Senior Appeals Representative
UnitedHealthcare
07.2019 - 04.2022
Senior Claims Auditor
International Medical Group
10.2018 - 07.2019
Global Underwriter
International Medical Group
04.2013 - 10.2018
Medical Underwriter
Tokio Marine HCC
05.2005 - 04.2013
No Degree -
Indiana University
High School Diploma -
Lawrence Central High School