AW
ANTHONY C. WILSON
**********@*****.*** 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