Summary
Overview
Work History
Education
Skills
Timeline
Generic

Tracy Fuller

Greensboro

Summary

Healthcare professional with 25 years of experience in claims processing, appeals, grievances, and provider data analysis. Demonstrated success in exceeding production and quality targets while ensuring compliance with industry standards. Expertise in training and supporting teams to enhance performance and efficiency.

Overview

26
26
years of professional experience

Work History

Provider Data Analyst

United Healthcare
Greensboro
10.2024 - Current
  • Analyzed provider demographics and credentialing for accuracy and compliance.
  • Monitored workflow efficiency to meet inventory goals and compliance standards.
  • Provided feedback to enhance processes and align productivity metrics.
  • Ensured verification of provider data and implemented necessary updates.

Senior Resolving Analyst

United Healthcare
Greensboro
02.2017 - 10.2024
  • Managed departmental inventory, ensuring compliance with regulations.
  • Supported training on pharmacy appeals, emphasizing workflow procedures and compliance guidelines.
  • Facilitated root cause analysis to drive process improvements and elevate quality standards.
  • Exceeded production and quality benchmarks through effective process management.
  • Collaborated with external teams on prior authorization denial resolutions.

Claims Adjuster

United Healthcare
06.2000 - 02.2017
  • Processed medical and dental claims using COSMOS platform efficiently.
  • Managed underpayment, closed, and denied claims for accurate adjustments.
  • Handled specialty claims, ensuring correct processing of infertility, transplants, and skilled nursing.
  • Collaborated with training teams to enhance understanding of small group accounts.

Education

Spelman college - Psychology

Spelman College
Atlanta, GA
01.1990

Skills

  • Research and analytical skills
  • Organizational skills
  • Workflow management
  • Inventory prioritization
  • Root cause analysis
  • Time management

Timeline

Provider Data Analyst

United Healthcare
10.2024 - Current

Senior Resolving Analyst

United Healthcare
02.2017 - 10.2024

Claims Adjuster

United Healthcare
06.2000 - 02.2017

Spelman college - Psychology

Spelman College
Tracy Fuller