At Aetna (CVS Health), I researched claims and eligibility data in HealthRules Payer, Salesforce, and mainframe systems to resolve coverage disputes. I documented member correspondence and maintained confidential patient records under HIPAA requirements.
I handled escalated cases involving prescription insurance, medication coverage, and mail-order pharmacy, and trained internal staff on service processes, policies, and escalation handling.
At Spectrum, I processed porting and activation requests and resolved complex failures, reducing processing errors by 30% and activation escalations by 25%. At U.S. Bank National Association, I recovered over $100,000 in outstanding debt across a six-month period.

