Kristy Foster

• Used critical thinking to break down problems, evaluate solutions and make decisions.
• Adaptable and proficient in learning new concepts quickly and efficiently.
• Learned and adapted quickly to new technology and software applications.
• Proved successful working within tight deadlines and a fast-paced environment.
• Evaluated coverage accurately by interpreting complex insurance policies and applying them to specific claim scenarios.
• Researched claims and medical policy information to deliver solutions and resolve problems.
• Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
• Evaluated new software tools that improved productivity levels while maintaining accuracy standards.
• Resolved complex claims issues for expedited processing and resolution.
• Developed customized reports for management review, highlighting key trends and areas of improvement in claims handling process.
• Collaborated with healthcare providers to obtain necessary documentation for claim support.
• Maintained strict compliance with HIPAA regulations, safeguarding patient privacy throughout the claim evaluation process.
• Managed high volume caseloads, prioritizing urgent and sensitive cases for immediate attention.
• Managed large volume of medical claims on daily basis.
• Identified and resolved discrepancies between patient information and claims data.
• Researched and resolved complex medical claims issues to support timely processing.
• Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
• Verified patient insurance coverage and benefits for medical claims.
• Monitored and updated claims status in claims processing system.
• Paid or denied medical claims based upon established claims processing criteria.
• Evaluated medical claims for accuracy and completeness and researched missing data.

• • Manage incoming customer service calls for BlueCare, Tenncare, Select Kids, and Choices members.
• Streamlined processes for improved efficiency in handling customer inquiries.
• Exceeded performance targets consistently through diligence, attention to detail, and strong problem-solving abilities.
• Worked closely with management to establish performance goals aligned with organizational objectives; regularly monitored progress toward these benchmarks.
• Established rapport with clients by actively listening to their needs and addressing concerns empathetically and effectively.
• Enhanced patient satisfaction by addressing inquiries and resolving issues related to medical appointments, billing, and insurance.
• Managed high call volume with professionalism and empathy, ensuring timely resolution of customer concerns.
• Handled sensitive patient information with confidentiality, adhering to HIPAA regulations at all times.
• Resolved escalated customer complaints efficiently while maintaining composure under pressure situations.
• Assisted in training new team members on company policies and best practices in medical customer service delivery.
• Maintained accurate documentation for all customer interactions, contributing to a comprehensive database for future reference.
• Work with TPL team from spreadsheets and facets to properly update member COB information
• Assist Quality Recruiting team in mentoring new hires
• Awarded 500$, 12 PTO hrs., and appointed to focus group for addressing Gaps in care, and highest performance in appointment scheduling

• Managed CMS/MARX reporting sent thru member Transaction Reply Codes and applied accordingly thru spreadsheets and Facets.
• Overseen data entry for CMS loads
• Tracked Misdirected mail and updated member information for proper mailing
• Verified member information for accurate enrollment and billing for new membership

• Accountable for database reporting to CMS for report deadlines

• Sustained required production and quality standards

• Communicated process improvements and goals thru productive team meetings

• Consulted with customers to determine best methods to resolve service and billing issues

• Cultivated impactful relationships with customers and drove business development by delivering

product knowledge

• Informed customers about billing procedures, processed payments and provided payment option setup assistance

• Met or exceeded revenue objectives by promoting DIRECTV to customers during service, account • and sales follow-up calls

• Addressed customer service inquiries quickly and accurately

• Documented conversations with customers to track requests, problems and solutions

• Assemble automobile parts to meet truck system broadcast schedule

Deliver parts to assembling area

• Locate and Monitor line equipment and computer programming output

• Set-up body harness and engine harness to broadcast requirements

• Set-up left side and right-side kits to meet broad<;ast schedule

• Stage goods and parts as required

• Assemble radios and telephones for the car system units

• Build units according to computer programming schedule

• Worked online in truck system within a five-job rotation

• Installed and Inspected parts on 52 second assembly

• Sustained high level of quality and production

• Operated confectionery machines.

• Organize materials for daily changeovers, operation, and inspection of machines

• Assisted kitchen in processing of gummy variety packs

• Troubleshoot all machinery in operation

• Inspect goods to determine quality standards

• Labeled and disposition completed goods

• Operated forklift for loading, unloading, and staging purposes

• Delivered material to line using control data and forklift equipment

• Operated under SAP computer program

• Lead soft candy Pre-shift meetings, and involved in implementing Lean Manufacturing standards

• Managed 30 to 60 people daily

• Assigned employees according to manufacturing schedule

• Reported directly to engineer on quality issues and procedures taken to solve those issues

• Assisted supervisor in interviewing potential employees, employee advancement, and disciplinary issues

• Trained and empowered employees on safety and process requirements

• Responsible for implementing, and following standard work procedures

• Operated LIMS and UTS machinery (lab testing equipment)

• Orchestrated and Organized changeovers for existing, and new innovations

• Communicated and Instructed process needs through employee Pre-shift meetings

• Analyzed data and trends through charting, and communicated findings

• Deviated and corrected process quality issues

• Operated forklift for the loading, unloading, and staging of goods

• Lead and participated in several Lean Manufacturing Projects

• Assisted in successful Green Belt Project that saved company 1.2 million dollars in first quarter

• Operated Converter/ Slicer equipment

• Accomplished tasks according to schedule and helped struggling team members

• Maintained open communication with systems operators to keep line product within specifications

• Practiced safe lockout-tagout procedures to prevent injury to personnel during maintenanc.e procedures

• Received and correctly processed both written and verbal instructions, prints and work orders