I've supported WellMed Medical Management/Optum since 2016, improving Network Operations and claims workflows as a Claims Business Process Consultant. I perform root cause analysis for Contract and Benefits Configuration barriers, manage monthly capitation payment reports, and facilitate claims inventory management between Network Operations and Claims.
I've identified automation opportunities for fee schedule data, tested claims-platform updates, and supported projects across Network Operations. Previously, I handled claim reconsiderations and maintained Provider Dispute Resolution requests within a 30-day turnaround time.
My background also includes medical claims processing, auto claims adjustment at USAA, customer service at SWBC and J. Crew, and leading summer travel teams for Lutherhill Ministries.
