AW

ANTHONY C. WILSON

ad3sbu@r.postjobfree.com 972-***-**** Arlington, TX 76001

Detail-oriented Senior Data Analyst driven to resolve claims fairly while representing interests of employer. Conducts thorough and informed investigations, precisely evaluates losses and negotiates settlements that satisfy diverse parties. Builds and maintains professional and productive relationships and works to understand potentially conflicting points of view.

Compliance Management

Documentation Review

Settlement Determinations

Allocating Claims

Data Entry

Insurance Claim Forms Review

Customer Service

Teamwork and Collaboration

Billing Software

Critical Thinking

Secure Data Practices

Policy Review

Composing Business Correspondence

Account Management Software

Records Management

Proficient in [Software]

Database Management

Insurance Terminology

Account Management

Regulatory Compliance Adherence

Claims Processing

Understanding of Medical Terms

Regulatory Compliance Understanding

Documentation Skills

Aetna / CVS Health

Claims Benefit Specialist / Sr. Data

Analyst

01/2018 - Current

Research and process claims according to the processing guidelines and benefits

Contact and follow up with members for additional correspondence Responsible for accurate and timely daily reports

Assists with the training of new hires

Third Party Administrator knowledge and experience Knowledge and use of ICD-9, ICD-10 and CPT coding

Provided independent decision making skills and demonstrated initiatives to resolve issues for internal and external customers Answered incoming calls while handling in-person inquiries Composed and typed routine letters and documented file activity on a regular basis on the PC

Processed and handled new non technical claims

Performed large data manipulation thru Excel and SQL with little supervision

Paid vendor statements and handled payment complaints and discrepancies

Processed checks, stop payments, cancellations, voids and journal entry payments.

Ascension Home Health Increased operational efficiency and company's profitability by timely and Summary

Skills

Experience

Business Analyst / Billing Specialist

01/2016 - 01/2018

accurately posting payments from patients and insurance companies

(Private Insurance, Medicaid, Medicare, and Workers Compensation)

Conducted thorough research to address patient and insurance company issues regarding physician signature errors, mask screens and the like Contacted 30-50/day insurance company representatives and patients to address account issues with timely and corrective measures Researched demographic and insurance information for completeness to correct any deficiencies and prevent delays in collection efforts On average, completed 75+ claims each day by ensuring claim files were properly documented and coded correctly

Aided in meeting daily departmental goals by decreasing days sales outstanding (DSO) and contributed to acquiring $1M cash potential Maintain proficiency in data entry, via Customer Information Control System (CICS) and other technologies and resources Verifying claim terminology UB=04 and 1500.

General Motors Arlington, Texas

General Assembler / Floating Assembler

Lead

01/2015 - 01/2016

Assembles motor vehicles, such as sport utility vehicles, at assigned work stations on moving assembly line, performing any combination of following repetitive tasks according to specifications and using hand- tools, power tools, welding equipment, and production fixtures: Loads stamped metal body components into automated welding equipment that welds together components to form body subassemblies

Positions and fastens together body subassemblies, such as side frames, underbodies, doors, hoods, and trunk lids, to assemble vehicle bodies and truck cabs preparatory to body welding process

Bolts, screws, clips, or otherwise fastens together parts to form subassemblies, such as doors, seats, instrument control panels, steering columns, and axle units

Installs mechanical and electrical components and systems, such as engine, transmission, and axle units; pumps; wire harnesses; instrument control panels; and exhaust, brake, and air-conditioning systems May work as a member of an assembly group and be assigned different work stations as production needs require or shift from one station to another to reduce fatigue factor.

JPMorgan Chase Irving, Texas

Customer Assistant Specialist/Inactive

Bankruptcy

01/2010 - 01/2015

Advice borrowers discharged from bankruptcy that is in foreclosure to educate them on options to resolve their delinquency and get out of foreclosure

Work directly with customers, title companies, and attorneys to facilitate and expedite Short Sale liquidation processes

Ran customer's financial information through Early Resolution system to qualify them for options based on their intent, ability to repay, and their current financial situations

Collect documents for workout options, which include listing agreements, and information for loan modifications.

Loss Mitigation Solicitor III

01/2009 - 01/2010

Counseled customers in foreclosure to educate them about options and methods for resolving delinquencies, including special servicing options, and then made appropriate recommendations

Provided consultation and collection efforts for avoiding foreclosure Used Early Resolution system to qualify potential customers for respective workout options and collected the related paperwork. Bank Owned Loans

Back End Collector

01/2008 - 01/2009

Achieved daily, weekly, and monthly goals for collections that were 31-120 past due

Worked closely with customers to set up payment arrangements on delinquent mortgage accounts

Identified problems for paying mortgages and offered alternatives to help clients resolve their mortgage issues

Referred accounts to in-house programs to prevent them from foreclosure Maintained monthly quality assurance averages, ensuring exemplary customer service on every call.

Relationship Manager

01/2010

Managed the customers' loan modification processes, communicated all required documentation and reviewed/analyzed all documents received from customers

Submitted files to the Underwriting department for decisions Ordered credit reports and Broker Price Opinions, reviewed Agent Desktop system to assist with customer disputes

Communicated post- underwriting decisions to customers, and collected final Modification Packages back from customers.

Texas A&M University Commerce, TX

Bachelor of Business Administration

Education and Training

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