Customer Service Management

Cheryl Davis

**** ********* *****

Morrow, GA ***60

**********@*****.***

404-***-****(M)

Profile

SR EPIC Application Coordinator, SR Benefit Analyst, SR HR Representative & SR Workers Compensation

Claims Administrator, with over 20 years of diverse career experience, including implementation of EPIC

Tapestry application, configuration and implementation of large groups benefit plans, data analysis, risk

management, training, recruitment, compensation, employee benefits, group facilitation, litigation, Superior

customer service and interpersonal skills with masterful oral and written skills. Excellent presentation skills.

Strong analytical and organizational skills. Demonstrated ability to influence others and impact change. Proven

leadership skills. Ability to work independently or in a team environment.

EXPERIENCE

06/2008 - 06/2014

Kaiser Permanente, Atlanta GA

EPIC Application Coordinator

Responsible for day to day administrative functions utilizing Benefits Engine, Tapestry & AP Claims

applications. Provided end-user support for EPIC Tapestry application. Responsible for analyzing, installing

and peering medical benefits for large group employers. Initiated timely and quality driven data of all hospital

and employer group benefits. Configure, build, test, validate and implement large group benefits. Complete

QA on all system builds and configurations to ensure accurate and timely implementation. Provided training to

providers and staff relating to EPIC workflow. Initiated and implemented ICD-10 workflow. Assisted with

design of workflow for referral generation from EPIC EMR orders. Assisted with the facilitation of physician

workgroups for the development of best practice protocols for Epic EMR build. Troubleshoot problems and

questions during training and go-live.

12/2004 - 11/2007

Broadspire, Atlanta, GA

Sr. Claims Examiner

Provided superior claims administration, risk management and quality investigation and analysis of complex

workers compensation claims in various jurisdictions. Investigated and evaluated liability. Analyzed, approved

& authorized benefits. Communicated effectively with injured worker, employer, nurse case management &

medical providers until resolution of claim. Coordinated return to work. Actively managed litigation process

and ensured timely and cost effective claims resolution. Negotiated settlement of claims while evaluating and

establishing timely and appropriate reserves. Established & implemented action plans for claim resolution,

including medical & disability management & litigation management. Planned and implemented techniques

for providing exceptional customer service and effective team building. Conducted service calls, workers

compensation presentations and claim reviews. Continued to support human resources.

10/2003 - 12/2004

MetLife, Alpharetta, GA

Sr. Benefit Analyst

Provided general employee relations support. Investigated and resolved employee issues. Recruitment thru

various sources. Administered and reviewed employment test; made recommendations on hiring decisions and

salary determinations. Prepared documentation for hiring, promotion or termination. Coordinated and

conducted new hire and benefit orientation. Prepared and reviewed data reports; identified issues and

communicated to HR management. Processed all workers compensation, unemployment and disability claims.

Conducted exit interviews. Assisted in directing and maintaining programs designed to enhance employee

morale. Responsible for the investigation, evaluation, interpretation & payment or denial of workers

compensation & LTD/STD disability claims. Interpreted contract provisions, vocational & medical records.

Maintained communication with claimants, nurse case management, policy holders, attorneys, physicians &

broker. Acted as resource to legal department as it related to compliance, legislature, legal & regulatory issues.

6/2000 - 2/2003

EBI/Royal Sun Alliance, Atlanta, GA

Sr. Business Partner

Performed a variety of Generalist task under the guidance of the HR Director, including total compensation

principles, small and large group facilitation, training, staffing, mentoring, career and salary management,

project management and employee relations. Assisted with various projects to ensure successful outcomes

relative to budget administration and stated objectives. Facilitated workshops for ergonomics, performance

management, diversity, health management, workers compensation, short/long term disability. Conducted new

hire orientation and assisted with recruiting and exit interviews. Identified issues impacting morale, job

satisfaction and turnover. Assisted with developing initiatives and recommendations to enhance employee

retention. Representative for unemployment and workers compensation claims. Investigated & determined

compensability of workers compensation claims. Evaluated facts obtained thru investigation & determined

extent of liability. Prepared reports on investigation, settlements & denials of claims.

6/1993 - 6/1999

AIG, Alpharetta, GA

Sr. Claims Examiner

Provided superior claims administration, risk management and quality investigation and analysis of complex

workers compensation claims in various jurisdictions. Investigated and evaluated liability. Analyzed, approved

& authorized benefits. Directed internal & external customers. Communicated effectively with injured worker,

employer, nurse case management & medical providers until resolution of claim. Coordinated return to work.

Actively managed litigation process and ensured timely and cost effective claims resolution. Conducted

departmental and client training.

EDUCATION

Argosy University, Atlanta, GA

Bachelor of Arts, Psychology

EPIC Certification – Benefit Engine, AP Claims, Tapestry (2014)

Argosy University, Atlanta, GA

Masters Public Health – Currently enrolled

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