Cortni Evans
Gastonia
Summary
Reliable and detail-focused professional with extensive experience in claims processing. Known for strong attention to detail and compliance, driving efficiency in claims investigation and benefit delivery.
Overview
15
15
years of professional experience
Work History
Claim Benefit Specialist
Aetna, a CVS Health
10.2019 - Current
- Process complex claims to ensure timely benefit delivery.
- Utilize advanced claims processing system to maintain accuracy and efficiency. (RUMBA/ECHS)
- Following policies and workflows to ensure compliance throughout the claims process.
- Review policy coverage details thoroughly before making determinations for each unique claim scenario presented.
- Review and process specialty claims such as Truman Group, COVID-19 over the counter tests, AHF, Medicaid, Military Treatment Facility, and CORR tasks.
- Review Debarred Provider list and request necessary ADHOC reports and send letters to members and providers of Debarred status.
- Review team letters to ensure correct plan and member information is selected and send feedback when needed.
- Mentor new hires and do sup review providing guidance and feedback to ready them for solo claim processing.
Deposit Operations Specialist
Aquesta Bank
10.2017 - 08.2019
- Trained new team members on deposit operations procedures and best practices to enhance team performance.
- Managed daily deposit operations tasks, ensuring accurate and timely completion of all transactions.
- Processed foreign items and returned mail.
- Immediately reported discrepancies and assisted in clearing discrepancies.
- Provided backup to other deposit operations specialists.
- Processed chargebacks.
- Processed levies, bankruptcy, and garnishment requests.
- Maintained confidentiality of bank's customers and adhered to all regulatory requirements.
- Executed wire transfers, stop payments and account transfers.
- ATM Terminal Balancing.
- ACH Returns/Corrections, Death Notification, & Prenotice Reports.
- Stop Payment/Hold Reports.
- Non-Post/NSF reports and handling.
- Document Imaging.
Retail Operations Specialist
Park Sterling Bank
04.2014 - 10.2017
- New and revised account document review.
- IRA account document review.
- IRA daily transaction report, add exceptions.
- Regulation CC Hold review and reports.
- Card-limit changes and dormant account reports.
- New online account application processing.
- iPay customer updates report.
- Doc Drop account review, importing and indexing into synergy.
- Wire and ACH document imaging BSA/Compliance document imaging.
- Charge off account processing and reports.
Deposit Operations Specialist
Alliance Bank and Trust
07.2012 - 04.2014
- Process rejected items related to deposit accounts, savings accounts, and general ledgers.
- Process returned checks, make entries to balance general ledgers and customer accounts.
- Handle all incoming wires (deposit) and post to appropriate customer accounts.
- Review Regulation CC Holds and Stop Payments.
- Process and make entries for ACH/Debit/ATM disputes.
- Maintain Error Resolution Log.
- Open and maintain Brokered Deposit Accounts and internet CDs.
Teller
Alliance Bank and Trust
10.2011 - 07.2012
- Making deposits
- Cashing checks
- Account transfers
- Loan payments
- Referring customers to open accounts
- Branch Capture Imaging
- Answering calls
- Recognized for perfect balancing
Customer Service Representative
Fifth Third Bank
09.2010 - 10.2011
- Making deposits
- Cashing checks
- Account transfers
- Referring customers to open accounts
- Branch Capture Imaging
- Overdraft calls
- Answering calls
- Recognized for being number 1 part-time employee for referrals for the month of March with 54 referrals.
- Was recognized at the 1st Quarter CSR luncheon on May 24th with 93 referrals.
Education
GED -
Gaston College
Dallas, North Carolina, NCSkills
- Microsoft Office
- Confidentiality handling
- Claims investigation
- Data Entry
- Claim Processing
- Teamwork and collaboration
- Attention to detail
- Problem-solving abilities
- Reliability
- Organizing and prioritizing work
- Adaptability and flexibility
- Conflict resolution
Timeline
Claim Benefit Specialist
Aetna, a CVS Health
10.2019 - Current
Deposit Operations Specialist
Aquesta Bank
10.2017 - 08.2019
Retail Operations Specialist
Park Sterling Bank
04.2014 - 10.2017
Deposit Operations Specialist
Alliance Bank and Trust
07.2012 - 04.2014
Teller
Alliance Bank and Trust
10.2011 - 07.2012
Customer Service Representative
Fifth Third Bank
09.2010 - 10.2011
GED -
Gaston College