Ann Platt

ad3zp0@r.postjobfree.com

763-***-****

SUMMARY OF QUALIFICATIONS

• Tested and documented rate changes in Facets, Stepwise to implement consolidations and conversions.

• Created and developed plans, implemented changes to tested rates in CRM, Test Client, and E-Store

• Imported data from Excel to work with other departments to implement changes and ensure accuracy.

• Acted as the liaison between Actuarial department and IT and updated E-Agency files.

• Organizes and used data mining processing to analytically prioritize completed work.

• Adapts well in a fast-paced and changing environment to follow established policies and guidelines.

• Intermediate to Advanced level of knowledge in Microsoft Word, Excel, and PowerPoint

• Arranged training materials and audited new hires to help them develop within the core curriculum.

• Experience in COSMOS claims platforms and in CDB, CPW, CRM, DOC360, E-Store, FACETS, HALLEY, ISET, ODAR, ORMS, PEGA, PICTS, Stepwise, Test Client, TIPS, TRCR, UNET and WAND

• Served as a Cultural Ambassador and gave multiple presentations on Core Value topics. EDUCATION

Bachelor of Science in Health Care Management Capella University Minneapolis, Minnesota (2020)

EXPERIENCE

Claims Experience

• Analyze and investigate claims using multiple medical platforms and applications.

• Ability to solve complex problems by utilizing computer research and investigated trends.

• Ability to communicate, understand and resolve stressful situations with confidence and competence with minimum supervision.

• Analyze and investigate any discrepancies that may arise during overpayment review.

• Conduct research of overpayments before recovery is initiated with providers, as well as with provider-initiated overpayments.

Customer Service Experience

• Validate and contact customers regarding inquiries and requested updates.

• Ability to respond to customer inquiries in an objective and efficient manner.

• Respond to inquiry inbound calls and making outbound calls using good business practices. EMPLOYMENT HISTORY

• UHC-E&I Econ and Pricing-Business Analysts (2022-8/2023)

• Optum Inventory Management Team-Recovery Resolution Analyst (2016-2022)

• Optum FWAE Support Services-Recovery Resolution Representative (2015-2016)

• Optum-Hi Health Innovations-Inside Sales Representative (2014- to 2015)

• OGI Eyewear- Customer Service Representative (2013 to 2014)

• Anoka Hennepin School District-Para Educator (2008-2013) JOB DESCRPTIONS

UHC-E&I Econ and Pricing-Business Analysts (6-2022-8/2023) Compared and tested healthcare cost structures and rate changes that interfaced with multiple systems. Created and developed test plans to implement changes in tested environments. Utilized and tested large data sets in Excel with the ability to identify missing data gaps and fix the root causes. Identified trends to problem solve issues. Analyzed and created Pivot tables and V-Lookup to solve complex business processes and outcomes. Developed quantitative, qualitative, analytical, presentations. Filtered large amounts of complex data and research findings to identify interdependencies and meaningful patterns and trends. Define and update the project schedule to track and measure the progress of the requirements-gathering process.

Optum Inventory Management Team-Recovery Resolution Analyst (2016-6/2022) Investigating, recovered and resolved a range of support services related to the processing, management, and resolution of insurance claims, invoices, outstanding balances, and other financial accounts. Perform data analysis to identify trends or predictive factors. Establish regular reporting requirements to review progress and mitigate potential issues. Discussed recommendations and findings.

Optum FWAE Support Services-Recovery Resolution Representative (2015-2016) Partnered with all other areas to proactively allocate resources to meet changing needs. Verified records and documentation and ensure that all required paperwork and supporting materials have been submitted properly. Conduct research of overpayments before recovery is initiated with providers, as well as with provider-initiated overpayments.

Optum-Hi Health Innovations-Inside Sales Representative (2014-2015) Used multiple platforms to sell Optum/UHC hearing aids. Validate and contact customers regarding inquiries and requested updates. Ability to respond to customer inquiries in an objective and efficient manner. Respond to inquiry inbound calls and making outbound calls using good business practices.

OGI Eyewear- Customer Service Representative (2013-2014) Communicate with customer inquiries verbally or in writing. Help customers compare products and services and advise clients about which options meet their needs. Provide clients with details about the company's products and services and share information related to pricing, product specifications and options.

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