Cici Edwards

I’m an experienced healthcare claims and operations professional specializing in complex claims research, benefit implementation testing, quality validation, issue resolution, and process improvement. I test claim outcomes before production, identify discrepancies, document findings, and work across Benefits, IT, Sales, providers, clients, and leadership to ensure accurate results.

I also serve as a subject matter resource for escalated claim issues and mentor approximately 10 analysts. My experience includes appeals and reconsiderations, payment corrections, client-specific and state-specific claims, reporting, documentation, administrative operations, and business support. I consistently maintain a high level of accuracy while managing detailed, time-sensitive work.

I’m interested in remote opportunities across claims operations, claims quality/QA, benefit implementation and testing, healthcare operations, business analysis, application support, investigations, risk review, data quality, case processing, and other back-office operations roles.