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LOUISVILLE, KY Street Address   PHONE NUMBER AVAILABLE  EMAIL AVAILABLEProfessional SummaryAccomplished professional with a proven track record at Elevance Health, excelling in roles requiring critical thinking, decision-making, and team collaboration. Expert in reconciling subsidy payments, enhancing system accuracy, and leading staff training initiatives. Demonstrates exceptional attention to detail and clear communication, significantly improving operational efficiency and quality standards.SkillsDecision-MakingTeam CollaborationAttention to DetailStaff TrainingRecords MaintenanceRecords ReviewWorkload ManagementQuality AssessmentRelationship BuildingMicrosoft Office proficientMicrosoft OfficeIssue ResolutionEmployee TrainingCritical Thinking and AnalysisClear CommunicationWork HistoryReconciliation Auditor II, 01/2014 to 02/2024Elevance Health  Louisville, KYReview files from state/federal exchanges for accurate information, make corrections to system when needed. Review subsidy information make any updates to system. Reconcile subsidy payments. Special projects as assigned by management including back up to Operation Expert. Train all new associates to area.Investigator, 05/2005 to 01/2014Elevance Health  Louisville, KYVerify the accuracy of member application with medical records after member was approved by underwriting and given premium based on application. Prepare case for Sr. Underwriter.Investigator-Special Investigations, 03/1995 to 05/2005Elevance Health  Louisville, KYReview applications for possible omissions that could result in higher rating or rescission of coverage. Review providers for possible claims abuse. Work with law enforcement and state Department of Insurance on cases.Claims, 06/1986 to 03/1995Elevance Health  Louisville, KYMultiple positions throughout the claims area that included processing easy claims into the system. I was Team Lead for a short period of time and I helped other processor with questions and to try to meed production and quality standards. Worked as a higher level processor on claims that did not go through the system on first pass. I also worked on Coordination of Benefits with primary and secondary insurance. We determined who was primary/secondary and processed claims accordingly with the other carrier EOB.EducationHigh School Diploma: 05/1982Western High School - Louisville, KY