SUMMARY
A highly skilled Health Operations Associate seeking to leverage extensive
experience in the BPO Healthcare Industry to handle claims processing tasks
efficiently, address patient and provider inquiries promptly and accurately,
and ensure adherence to HIPAA regulations. Proficient in healthcare management
software, MS Word, and Excel for reporting and documentation purposes.
EXPERIENCE
Business Operations Associate
Accenture
July 2023 – February 15, 2025
-Responsible for
monitoring Tenured ASE in ATCP and identifying supply-demand gaps.-Serve as the primary
point of contact for resolving issues reported on the ticketing site. - Monitor, track, and
approve the demands of contractors.
Claims Auditor
Accenture-
WGS Adjustment
January 2022 to May 24, 2023
- Conduct post-payment audits for all claim types to ensure
payment or rejection accuracy based on contractual policies and
procedures.
- Compiled audit findings for medical claims
and communicated results to Leads.
Inquiry Tracking Processor/Customer Service
Advocate
Accenture-ACA
Correspondence
January 2019 to April 2021
- Managed provider and member’s queries and
provide resolution.
- Proofread documents (e.g., medical records,
member forms) to address member and provider inquiries.
- <!--[endif]-->Consistently met daily productivity targets
while maintaining a 100% quality score.
Claims Processor
Accenture-National
Accounts
May 2012 to December 2018
- Proficient
in processing claims for all claim types.
- Exceeded
daily productivity targets and maintained a 100% quality score.
- Collaborated
closely with teammates to resolve a large volume of aging claims daily.
