Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Karen Rainey

Chesterfield

Summary

Operations expert specializing in process optimization and data analysis. Demonstrated success in mentoring teams and developing training materials. Proven ability to enhance operational efficiency through effective collaboration and strategic initiatives.

Overview

16
16
years of professional experience
1
1
Certification

Work History

Operations Expert

WellPoint, Anthem Blue Cross
Richmond
02.2018 - 05.2021
  • Mentored professionals on responsibilities and procedures to boost performance.
  • Developed training materials for onboarding new team members effectively.
  • Monitored operations, reviewing records and metrics to evaluate company performance.
  • Cultivated positive relationships with staff and management to enhance collaboration.
  • Conducted root cause analysis to address and troubleshoot operational issues.

Operations Recovery Specialist I, II, III

WellPoint, Anthem Blue Cross
Richmond
12.2004 - 01.2018
  • Conducted extensive research on multiple projects to identify root causes of issues.
  • Created solicitation requests addressing overpayments from hospitals and physician offices.
  • Initiated cash adjustments to reconcile overpayments returned by facilities and physicians.
  • Communicated with facilities and physicians via customer service lines to provide clarifications.
  • Processed claims efficiently, ensuring accuracy and compliance.

Education

Some College (No Degree) - Certification Medical Biller

Bryant And Stratton College
Richmond, VA

Some College (No Degree) - Business Information System

Virginia State University
Petersburg, VA

Skills

  • Process optimization
  • Data analysis
  • Operations monitoring
  • Training development
  • Root cause analysis
  • Customer relationship management

Certification

Certified Medical Biller

Timeline

Operations Expert

WellPoint, Anthem Blue Cross
02.2018 - 05.2021

Operations Recovery Specialist I, II, III

WellPoint, Anthem Blue Cross
12.2004 - 01.2018

Some College (No Degree) - Certification Medical Biller

Bryant And Stratton College

Some College (No Degree) - Business Information System

Virginia State University
Karen Rainey