Katherine Holmes

Katherine Holmes CELL - EMAIL-ADDRESS 116 PROFFITT R IDGE R OAD M OORESBURG , TN 37811 OBJECTIVE Seeking a position where my skills and experience can be used in day to day operations. I am an experienced professional working in a fast-paced environment demanding strong organizational, technical, and interpersonal skills. Highly trustworthy, ethical, and discreet; committed to superior customer service. Detail-oriented and resourceful in completing projects; able to multi-task effectively. Capabilities include: 14+ years in managed care/medical insurance experience. 10+ years experience in a claims, customer service or provider support role. 5+ years in claims, auditing, processing and research. Extensive work experience within own function. Mentors and acts as a technical resource providing expertise and claims support to others. Able to plan, prioritize, organize and complete work to meet established objectives. Proficient with MS Excel and Microsoft Word. Proficient with CSP Facets 540 and CSP Macess EXP Applies knowledge/skills to a range of moderately complex activities. Demonstrates a depth and breadth of knowledge/skills in own area and is often able to apply these outside of own function. Solves complex problems on own; proactively identifies new solutions to problems. Acts as a facilitator to resolve conflicts on the team; seen as a key team member on projects spanning more than own function. Acts as a facilitator to resolve conflicts on team; seen as a key team member on project teams spanning more than own function. PROFESSIONAL REFERENCES 1. Betty Fretwell, Manager Recovery/ReSols (Phone- (Email)-2. Jessica Schexnayder, Assc Bus Anlyst (Phone- (Email)-3. Kathaleen Lynch, Claims Supervisor (Phone- (Email)- PROFESSIONAL EXPERIENCE • FEB 19, 2016 - current UHC Benefit Ops - Shared Svcs (Telecommuter) o Position: Claims Adjustment Specialist, Subject Matter Expert Payment Integrity (Sam Edit) – Now known as CCM Prepay o Assisted with the One Prepay project to develop another Claims Audit Platform for the company (CAP Tool) I then became the subject matter expert for the new CAP Tool and was responsible for training and managing a team of analysts o Assisted with many different projects with High Dollar and Automation • JAN 25, 2015 – FEB 19, 2016 UHC Benefit Ops - Shared Svcs (Telecommuter) o Position: Claims Adjustment Rep, Payment Integrity • FEB 2009- JAN 2015 United Healthcare, Kingsport, TN o Position: Senior Customer Care Professional, Member/Provider Services • DECEMBER 2008-FEBRUARY 2009 County Today Hancock o Position: Office Manager ▪ Classified Advertising and Graphic Design ▪ A/R and A/P, Payroll ▪ Organizing and managing a small staff • (No longer with the company due to taking a position with United Healthcare) • AUGUST 2007-NOVEMBER 2008 o Position: Office Manager ▪ Medical Secretary/Receptionist Horizon Healthcare Services Rutledge, TN ▪ Insurance Verification, Authorizations and Benefits ▪ Follow-up on claims payments • ▪ Accounts payable for in-house staff and accounts ▪ Travelled to second location twice a week to maintain records and staffing as needed • (No longer with the company since they went out of business) MAY 2005 – MARCH 2007 Station, TN o Position: Accountant / Office Manager ▪ A/R and A/P, Payroll ▪ ▪ Advertising Sales / Graphic Design Customer Service / Reception ▪ Circulation and Distribution Grainger Today, Inc Bean