Ayla Hartley
Caboolture
Summary
Results-driven professional with comprehensive background in claims management and proven ability to streamline processes. Ensuring smooth operations and goal attainment. Highly proficient in data analysis and problem-solving, valued for reliability and commitment to excellence.
Overview
19
19
years of professional experience
Work History
Claims Processor
AAS
07.2017 - 12.2024
- Reviewed policy information to ensure compliance with company procedures and guidelines.
- Provided customer support by addressing questions related to claim status and requirements.
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Managed workload and priorities to meet claims processing meet deadlines.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Responded to customer inquiries, providing detailed explanations of insurance policies and claims processes.
- Assisted in onboarding of new claims processors to familiarize with company procedures, policies and processes.
- Developed strong relationships with healthcare providers and insurance agents to facilitate seamless communication during the claims process.
- Calculated adjustments, premiums and refunds.
- Posted payments to accounts and maintained records.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
Store Manager
IGA Supermarket
01.2006 - 05.2015
- Led daily operations, ensuring optimal store performance and customer satisfaction.
- Fostered a positive work environment, mentoring team members for career growth.
- Analyzed sales trends to drive merchandising strategies and improve inventory management.
- Addressed customer complaints promptly and professionally, resolving issues to maintain positive relationships with clientele.
- Managed store employees successfully in fast-paced environment through proactive communication and positive feedback.
- Mentored new hires during their onboarding process, ensuring they were well-equipped to excel in their roles from day one.
- Rotated merchandise and displays to feature new products and promotions.
- Set effective store schedules based on forecasted customer levels, individual employee knowledge, and service requirements.
- Collaborated with other managers to develop company-wide initiatives aimed at improving overall performance across all locations.
- Developed strategies for attracting new customers by analyzing demographic data and conducting targeted marketing initiatives.
- Negotiated with vendors to introduce new products that matched consumer trends, keeping store's offerings fresh and appealing.
- Fostered culture of excellence and accountability among staff, resulting in higher employee morale and lower turnover rates.
- Streamlined store operations to reduce costs, negotiating with suppliers for better pricing and optimizing staff schedules for peak times.
- Increased community engagement by participating in local events and sponsoring youth sports teams, raising store's profile.
Education
Diploma - Medical Laboratory Science
TAFE NSW
Newcastle, NSW06-2018
Medical Termonology - Medical Technology
NSW TAFE
Penrith02-2017
Skills
- Claims review
- Claims processing software
- Policy interpretation
- Regulatory compliance
- Data entry proficiency
- Medical terminology
- Insurance regulations
- Payments posting
- Data integrity
- New policies processing
Timeline
Claims Processor
AAS
07.2017 - 12.2024
Store Manager
IGA Supermarket
01.2006 - 05.2015
Diploma - Medical Laboratory Science
TAFE NSW
Medical Termonology - Medical Technology
NSW TAFE