Teresa Trueblood
Hinesville
Summary
Seasoned Claims Supervisor with comprehensive knowledge in managing insurance claims processes and leading teams. Highly skilled in investigating complex claims, interpreting policies, and resolving disputes efficiently. Notably improved claim resolution times and customer satisfaction rates by implementing streamlined procedures. Bring strong leadership abilities, critical thinking skills, and commitment to continuous improvement.
Overview
17
17
years of professional experience
Work History
Claims Supervisor
DELTA DENTAL INSURANCE COMPANY
Alpharetta
10.2020 - Current
- Supervise staff including staff evaluation and performance monitoring; trains and coaches staff to assist in professional development and ensure superior work quality.
- Track workload and inventory to allocate staff and resources efficiently; adjust as necessary to meet production goals and maintain service standards.
- Ensure projects are completed accurately and on schedule; intervene as needed.
- Adjust staffing based on departmental workload to meet production and service standards.
- Prepare and maintain productivity and inventory reporting statistics and review with staff members and leadership.
- Review productivity and inventory reports with teams and leadership.
Grievances and Appeals Specialist
DELTA DENTAL INSURANCE COMPANY
Alpharetta
06.2018 - 10.2020
- Research and respond directly to members, providers, clients, internal departments and regulatory bodies.
- Reports complaint trends to legal counsel and management as determined by analysis of the complaint tracking system.
Claims Examiner II
DELTA DENTAL INSURANCE COMPANY
10.2011 - 06.2018
- Establish and maintain lines of communication with groups that have special requirements that will help to better the work flow of the claim process.
- Monitor reports with claims that are aging and denying while developing a plan of action to make sure that the group/provider are in compliance with the polices.
Claims Specialist
WIPRO-UNITED HEALTHCARE INSURANCE
Buckhead
10.2008 - 09.2011
- Ensure that the claims are being received, review and audit in a timely manner.
- Maintain accurate reports about groups/providers that are having problems submitting their information through our health system.
Education
Bachelors of Science - Healthcare Administration
Columbia Southern University
Long Beach, AL01.2026
Associate of Science - Health Information
Columbia Southern University
Long Beach, AL02.2017
Medical Billing and Coding
Everest Institution
Jonesboro, GA01.2010
Skills
- Healthcare management
- Claims processing
- Data analysis
- Regulatory compliance
- Staff training
- Effective communication
Timeline
Claims Supervisor
DELTA DENTAL INSURANCE COMPANY
10.2020 - Current
Grievances and Appeals Specialist
DELTA DENTAL INSURANCE COMPANY
06.2018 - 10.2020
Claims Examiner II
DELTA DENTAL INSURANCE COMPANY
10.2011 - 06.2018
Claims Specialist
WIPRO-UNITED HEALTHCARE INSURANCE
10.2008 - 09.2011
Bachelors of Science - Healthcare Administration
Columbia Southern University
Associate of Science - Health Information
Columbia Southern University
Medical Billing and Coding
Everest Institution