Marie Moore
High Point
Summary
Detail-oriented professional specializing in financial auditing and claims processing. Demonstrated success in operational improvements and compliance, resulting in substantial financial recoveries. Possesses strong analytical and problem-solving skills that enhance team effectiveness and drive measurable results.
Overview
34
34
years of professional experience
Work History
Financial Recovery Specialist
BCBSNC
Durham
12.2012 - Current
- Facilitated transfer of over 12 million dollars for Amisys to Facet project in two years.
- Created invoices and posted credit memos, ensuring accurate financial records.
- Supported recoupment efforts for Optum DRG project, maintaining strict compliance and accuracy.
- Processed audits and trained offshore team on Pareo, enhancing operational efficiency.
- Generated critical reports, including Pareo and Daily Inventory reports for analysis.
- Collaborated with departments to resolve inquiries regarding refunds and recovery.
- Executed claims processing for electronic and manual submissions, achieving departmental quality goals of 98% or better.
- Maintained weekly Check run error report while assisting with T3 audits via third-party vendor.
ASA/SRC Claims Benefit Specialist
Aetna
High Point
03.2008 - 01.2011
- Priced provider and facility claims daily, exceeding productivity of 225 submissions.
- Managed departmental research mailbox for TPA inquiries and Network Manager concerns.
- Generated weekly and monthly financial reports through spreadsheets and collaborative conference calls.
- Delivered training and coaching to enhance skills of other claim specialists.
Customer Care Professional
United Health Care
Greensboro
12.2005 - 03.2008
- Handled 80 to 110 inbound calls daily, providing efficient customer support.
- Quoted and explained plan benefits to members and providers for enhanced understanding.
- Assisted in locating contracted providers and hospitals to facilitate member access.
- Resolved inquiries regarding Explanation of Benefit statements, ensuring clarity and satisfaction.
Team Lead / Coordinator
Bank of America
Greensboro
05.1992 - 04.2002
- Coached and managed 12 associates within call center environment to enhance performance.
- Oversaw recovery team responsibilities for accounts 0-120 days delinquent.
- Removed late fees and resolved delinquencies to improve customer satisfaction.
- Updated and corrected credit bureau files due to company errors.
- Documented third-party contracts, including attorneys, credit bureaus, and dealerships.
Education
Associate of Arts - College Transfer
GTCC Jamestown
Jamestown, NC05-1988
Some College (No Degree) - Nutrition
UNC Greensboro
Greensboro, NCSome College (No Degree) -
Wilkes Community College
Wilkesboro, NCSkills
- Financial auditing and compliance
- Claims processing and invoice creation
- Data analysis and report generation
- Operational efficiency and problem solving
- Training and coaching with attention to detail
References
References available upon request.
Timeline
Financial Recovery Specialist
BCBSNC
12.2012 - Current
ASA/SRC Claims Benefit Specialist
Aetna
03.2008 - 01.2011
Customer Care Professional
United Health Care
12.2005 - 03.2008
Team Lead / Coordinator
Bank of America
05.1992 - 04.2002
Associate of Arts - College Transfer
GTCC Jamestown
Some College (No Degree) - Nutrition
UNC Greensboro
Some College (No Degree) -
Wilkes Community College