As a Process Specialist – Data with a focus on US healthcare claims analysis , I bring extensive experience in data analysis , process optimization , and cross-functional collaboration . Proficient in SQL, AI tools, and Excel , I specialize in extracting and validating large datasets to ensure accurate claims processing in alignment with client-specific guidelines.
Currently, I lead and mentor a team of 25+ associates (FTEs) , providing strategic direction, performance oversight, and hands-on training to drive team excellence. I have successfully designed and delivered training programs for new hires , existing team members, fostering a culture of continuous learning and high performance.
With strong analytical skills, I identify payment discrepancies, generate actionable insights, and offer data-driven recommendations for claim reprocessing. I collaborate closely with Configuration, Regulatory, and IT teams to resolve complex issues and streamline operations. Passionate about leveraging data and AI-driven solutions to enhance decision-making and optimize workflows, I am committed to delivering consistent improvements in claims processing outcomes.
Thorough team contributor with strong organizational capabilities. Experienced in handling numerous projects at once while ensuring accuracy. Effective at prioritizing tasks and meeting deadlines.
Results-oriented achiever with proven ability to exceed targets and drive success in fast-paced environments. Combines strategic thinking with hands-on experience to deliver impactful solutions and enhance organizational performance.