Gloria Hunter, Macl

Gloria Hunter, Macl Email and Phone Number

Senior Claims Analyst @ Personal care
Birmingham, AL, US
Gloria Hunter, Macl's Location
Greater Birmingham, Alabama Area, United States
About Gloria Hunter, Macl

A good leader works to create high functioning employees or groups and prepares them for leadership. Helping others to find their strengths and weaknesses and work to captialize on both attributes drives the best outcomes in people and organizations. This has been my encouragement to others and to myself, throughout my work experience, and mentoring classes. Performing well takes intentionality and collaboration. No one does anything successful by themselves. Therefore my professional and volunteering experience and personal aspirations are a collaberation of many who took the time to invest in me.My desire is to positively influence, encourage and motivate others to higher heights and deeper depths to meet company and personal accomplishments. What I give to others I get back in the success they achieve. As a Manager and Supervisor, I have found that when you invest in employees professionally and personally they win, you win, and business wins. Consequently, my experience as a Supervisor for 12 years has provided me a wealth of knowledge from an HR prospective of recruiting, hiring and managing employees. I also have learned to create and deliver training tools and modules that merit and move business objectives. My success is in assessing projects and managing staff to support those demands. My position as a Self Esteem Faciliator is most rewarding because it has become my assignment to help build others to see their potential.My goals today are to continue to motivate any and all those I become accountable to lead and take great effort to deposit all I have learned in the next generation of leaders.Volunteering with young girls provides to me the opportunity to give back to my community by becoming an influencer in achievement and change for my community.

Gloria Hunter, Macl's Current Company Details
Personal care

Personal Care

View
Senior Claims Analyst
Birmingham, AL, US
Website:
naphcare.com
Employees:
761
Gloria Hunter, Macl Work Experience Details
  • Personal Care
    Senior Claims Analyst
    Personal Care
    Birmingham, Al, Us
  • Naphcare, Inc.
    Senior Claims Analyst
    Naphcare, Inc. May 2023 - Present
    Birmingham, Alabama, United States
  • Phenomenal Women Foundation Inc. Birmingham Al
    Raising Ruth'S Girl'S Mentoring Program
    Phenomenal Women Foundation Inc. Birmingham Al Mar 2023 - Present
    Birmingham, Alabama, United States
  • Cvs Health
    Appeals Coordinator
    Cvs Health Nov 2021 - Present
    United States
  • Flock Inc.
    Flock Inc. Ministry / Ceo
    Flock Inc. Mar 2012 - Present
    Flock- First Lady'S Of Christ The King (Facebook Page)
    FLOCK Inc, (First Lady's of Christ the King) Is the gathering of Christian Women who want to do ministry within the communities we serve. Our desire is to provide support in areas of Parenting, Education classes and provide encouragement for young women at risk and more. If you are a a Christian woman we look forward to you joining us in this community mininstry that crosses all demoninations. We want to take the gospel to the people through this ministry of encouragement. Completed assignment with The Youth Project, Donielle Owens-Diggs Alternative program at Penn Hills High School administering Self Esteem Classes May 2013 (8 months)
  • Flock Inc.
    Self Esteem Mentor /Facilitator/Volunteer
    Flock Inc. Oct 2012 - Present
    Presentation Group
    Presenter of Self Esteem work shops at Penn Hills High School. Currently a Volunteer Resource Group looking to support existing organizations with social programming.
  • Upmc Children'S Hospital Of Pittsburgh
    Patient Relations Specialist
    Upmc Children'S Hospital Of Pittsburgh Jan 2020 - Jun 2021
    Pittsburgh, Pennsylvania, United States
    Work with Parents and Senior Leadership to resolve clinical and service related issues.Work with Senior Leadership to investigate complaints and Grievances.Manage a daily inventory and turnaround times.Manage Patient experiences and provide information.
  • Upmc Health Plan
    Technical Claims Specialist
    Upmc Health Plan May 2018 - Jan 2020
    Pittsburgh, Pennsylvania, United States
  • Upmc Health Plan
    Claims Supervisor
    Upmc Health Plan Apr 2017 - May 2018
    Pittsburgh, Pennsylvania, United States
    Managed Telecommuter staff as well as in office staff responsible for claims processing Behavioral Health Insurance claims. Managed workflow and projects for process improvements and employee initiatives. Recruited and Interviewed staff.
  • Ifg - International Financial Group
    Claims Followup Specialist
    Ifg - International Financial Group Oct 2016 - Apr 2017
    Worked at Allegheny Health Network Revenue Cycle division. Responsible for the swift adjudication of claims. Work to expedite claims with providers and internal departments. Proficient with several processing systems to research protocols and processes to ensure financial returns are met weekly and monthly. Experience with EPIC and Meditech, Med-Asset and Sovera systems.
  • Gateway Health Plan
    Claims Manager
    Gateway Health Plan Mar 2016 - May 2016
    Greater Pittsburgh Area
    Hired as a Claims Manager within a recovery unit. Position was eliminated two months after I arrived. As a result, currently working in Non Profit Flock Inc. Which is a women and girl mentoring group.
  • Wexford Health Services
    Claims Manager
    Wexford Health Services Jun 2015 - Mar 2016
    Greater Pittsburgh Area
    Wexford Health provides healthcare for incarcerated State and Local Jailed inmates within Pennsylvania, Illinois, Florida, Maryland and West Virginia. I have the responsibility to serve as a Claims manager working with compassionate people who care about the "least of these"​ to provide medical healthcare. In this position I lead some experienced employees that have a wealth of knowledge and concern for working medical health claims.We work to "RAISE the Standard" our core value statement, to be Responsive and innovative, Adaptable and Efficient, Integrity driven with excellence, Superior Service, by Engaging our workforce motivated to achieve company goals. I thank each of those who work with me to shine bright in their position while working a community service mission of providing healthcare to those who need it.
  • Verisure Background Screener Llc
    Business Owner
    Verisure Background Screener Llc Sep 2014 - Mar 2015
    Po Box 8804 Pittsburgh Pa 15221
    Verisure Background Screener LLC, a new premier pre-employment background and tenant screening company designed to provide accurate and timely background histories for small to medium companies and non profit organizations. We provide investigations for industries such as Medical offices, hospitality, Home Health agencies, Insurance, Manufacturing and more. We package your request and provide support with managing adverse information. We want you to "Be Verisure of the facts" visit our website at www.verisurebackground.com
  • Prior Positions
    Appeals Manager
    Prior Positions Jan 2014 - Nov 2014
    Greater Pittsburgh Area
    An administrator of Appeals for the Wearable Cardiac Defibrillator, called the Life Vest. A one of a kind device used to help keep patients alive when they are in need of a transplant or Surgery. The vest provides electronic shock in the event of cardiac event before a permanent solution can be obtained. This vest saves and secure lives. We help people secure lifesaving equipment.
  • Novitas Solutions/ Formally Highmark Medicare Services
    Claims Operations Supervisor
    Novitas Solutions/ Formally Highmark Medicare Services Jan 2005 - Mar 2013
    Greater Pittsburgh Area
    As a supervisor I am responsible to recruit, train and supervise Claims processors and QIC claims clerks. I have developed an environment in which assignments are completed timely and efficiently. I developed processes and procedures that helped direct employee efficiencies and have coordinated job activities to support program requirements. Monthly the corporate goals are met.PROJECTSSuccessfully managed the implementation of the Teleform system that delivered case receipts via Fax machine. Facilitated and participated in a work group discussions to manage issues as they arose. Implemented process improvements for foreign claims, Outlier and MSP processes into procedures for departmental use. These improvments helped with claims timeliness as well as quality goals.Other Accomplishments include requesting a system program be generated to extrapolate the Chief Financial report data. A Large report had to be hand counted and it was determined that a systematic report could be compiled to generate the total amounts. This improvement increased the productivity of report accuracy and timeliness.3 projects I presented became the division's initiatives and they include comparing and updating of processing procedures or Reason Codes within the unit. This improvement reduced codes to the necessary codes increasing productivity.The reduction of override errors through the review of override usage reduced override errors and improved the quality rating with the division. Crossed trained staff to increase productivity on all lines of business, resulting in staff reducing Claims backlog. Additionally, I was responsible for identifying deficiencies or inefficiencies in documented policy procedures. One such example, I suggested the reduction of multiple Medicare Summary Notice prints which was implemented and resulted in the deletion of the document creating a cost savings.
  • Highmark Inc
    Claims Supervisor
    Highmark Inc Jan 2000 - Dec 2005
    I managed all lines of business within claims processing. Worked with Indemnity, Major Medical, HMO Medigap and Point Of Services product lines. Developed and trained staff to complete assignments timely and efficiently. Monitored outsource company Walsh Health Care inventory and Regence Blue Cross Blue Shield and administered financial reimbursements and quarterly reports monthly. Also supervised 12 Imaging Staff due to operational realignment. I was responsible for claims being sorted and Imaged and was accountable for monitoring outsourced claim completion. Currently work in Novitas (formally Highmark Medicare Services)
  • Highmark Inc.
    Operations Claims Trainer
    Highmark Inc. Jan 1998 - Jan 2000
    Trained newly hired employees on Indemnity Blue Cross Blue Shield, Point Of Service, HMO, Health Management Organization, claims processes. Developed training methods, tracked and monitored class success rates to help support company demands for skilled processors. Successfully trained over 20 classes both new hire and existing staff.Introduced training programs that enhanced employee performance and helped build a motivated workforce. Successfully trained staff that has been promoted to higher level positions within the corporation.

Gloria Hunter, Macl Skills

Leadership Team Building Social Media Public Speaking Human Resources Insurance Sales Event Planning Organizational Vision Negotiation Excel Team Leadership Process Improvement Fundraising Strategic Planning Organizational Development Outlook Microsoft Office Microsoft Word Operations Management Entrepreneurship Program Management Employee Relations Marketing Social Networking Nonprofits Leadership Development Event Management Change Management Training Policy Community Outreach Time Management Customer Service Editing Program Development Budgets Management Teamwork Staff Development Coaching Public Relations Research Problem Solving Project Management Organizational Leadership Recruiting Volunteer Management Workshop Facilitation Analysis

Gloria Hunter, Macl Education Details

Frequently Asked Questions about Gloria Hunter, Macl

What company does Gloria Hunter, Macl work for?

Gloria Hunter, Macl works for Personal Care

What is Gloria Hunter, Macl's role at the current company?

Gloria Hunter, Macl's current role is Senior Claims Analyst.

What schools did Gloria Hunter, Macl attend?

Gloria Hunter, Macl attended Liberty University, Carlow College, Mt Carmel Baptist Church, First Antioch Baptist Church.

What skills is Gloria Hunter, Macl known for?

Gloria Hunter, Macl has skills like Leadership, Team Building, Social Media, Public Speaking, Human Resources, Insurance, Sales, Event Planning, Organizational Vision, Negotiation, Excel, Team Leadership.

Who are Gloria Hunter, Macl's colleagues?

Gloria Hunter, Macl's colleagues are Gabriel Gallegos, Nicole Gomez, Krista Pettus, Jim Jones, Robin Myers, Tiffany Campbell-Moore, Anna Garvin.

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