Heather McClelland
Medina,WA
Summary
Dynamic Senior Claims Processor with extensive experience at HBF Health Insurance, excelling in claims processing and data analysis. Proven ability to mentor teams and enhance workflows, ensuring compliance and accuracy. Strong communicator with a keen attention to detail, driving procedural improvements and fostering relationships across departments.
Overview
25
25
years of professional experience
Work History
Senior Claims Processor
HBF Health Insurance
Perth, WA
07.2020 - Current
- Reviewed and processed health insurance claims for accuracy and compliance.
- Collaborated with hospital providers to resolve claim discrepancies, enhancing accuracy in claims processing.
- Mentored claims processors on best practices and company procedures.
- Utilized claims processing software to track and manage workflows efficiently.
- Ensured timely resolution of complex claims issues through effective communication.
- Assisted in training new staff on claims processing systems and protocols.
- Analyzed claim trends to identify procedural improvements, contributing to streamlined processing workflows.
- Maintained up-to-date knowledge of industry regulations affecting claims processing.
- Communicated effectively with team members across multiple departments within the organization.
- Assisted in developing new policies and procedures related to claim processing operations.
- Delivered advanced technical coaching to team members.
- Facilitated team meetings to discuss goals, challenges, and progress updates regularly.
- Assisted team leader in managing daily operations, delegating tasks and monitoring performance.
- Monitored workflow and identified areas for improvement in order to maximize productivity levels.
- Provided technical support to team members when needed.
- Encouraged teamwork among staff members by recognizing individuals' contributions towards overall success.
- Reviewed completed work to verify consistency, quality, and conformance.
- Collaborated with other departments to streamline processes and improve interdepartmental cooperation.
- Championed the adoption of new technologies to improve team productivity and service delivery.
- Maintained positive working relationship with fellow staff and management.
Customer Service Representative
Westpac Banking Corporation
Norwood, SA
04.2011 - 06.2012
- Assisted customers with inquiries regarding banking products and services.
- Resolved customer complaints through effective communication and problem-solving skills.
- Processed transactions accurately while ensuring adherence to company policies.
- Educated customers on digital banking tools and features for enhanced usability.
- Maintained up-to-date knowledge of banking regulations and compliance requirements.
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Answered customer inquiries and provided accurate information regarding products and services.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- Asked probing questions to determine service needs and accurately input information into electronic systems.
Customer Service Representative
Westpac Banking Corporation
Exmouth, WA
07.2001 - 07.2010
- Provided exceptional customer service to customers by answering inquiries, resolving complaints and processing transactions in a timely manner.
- Assisted customers with account inquiries and provided product information.
- Assisted customers with opening new accounts, ordering checks, and setting up online banking services.
- Identified customer needs and recommended suitable banking products and services.
- Identified customer financial needs, goals and objectives and offered appropriate financial products to suit needs.
- Cross-sold bank products such as savings accounts and credit cards to existing clients.
- Met or exceeded sales goals by promoting bank products and services in customer interactions.
- Maintained knowledge of banking regulations and compliance requirements.
- Maintained confidentiality of bank records, transactions and customer information.
- Explained bank services, financial products and applicable fees to customers.
- Trained new tellers on operational procedures and customer service standards.
- Processed customer transactions efficiently and accurately at a major financial institution.
- Balanced cash drawers daily to ensure accuracy and accountability.
- Handled large sums of money with accuracy while maintaining appropriate levels of security.
- Adhered to strict guidelines regarding financial and customer data to avoid breaches and information misuse.
- Identified and reported suspicious behavior to security personnel as appropriate.
- Built and maintained client relationships through quality, personalized interactions.
- Stepped in as relief branch manager when required.
Education
Exmouth District High School
Exmouth, WASkills
- Claims processing
- Insurance regulations
- Data analysis
- Workflow management
- Risk assessment
- Training and mentoring
- Effective communication
- Attention to detail
- Time management
- Teamwork
- Data entry
- Relationship building
References
References available upon request.
Timeline
Senior Claims Processor
HBF Health Insurance
07.2020 - Current
Customer Service Representative
Westpac Banking Corporation
04.2011 - 06.2012
Customer Service Representative
Westpac Banking Corporation
07.2001 - 07.2010
Exmouth District High School