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
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
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
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
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
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
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
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