Sonja Payne

Sonja Payne Email and Phone Number

Mgr-Enterprise Business Solutions at GEHA Health @ GEHA Health
Sonja Payne's Location
Kansas City Metropolitan Area, United States, United States
Sonja Payne's Contact Details

Sonja Payne personal email

n/a

Sonja Payne phone numbers

About Sonja Payne

Enthusiastic professional with special strengths in leadership, process management, technology improvements, training, and customer service. A creative thinker with an outstanding record of accuracy, working with a positive attitude and a strong work ethic. Proven performance in leadership, technology development, organization skills, coordinating procedure and workflow processes.

Sonja Payne's Current Company Details
GEHA Health

Geha Health

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Mgr-Enterprise Business Solutions at GEHA Health
Sonja Payne Work Experience Details
  • Geha Health
    Mgr-Enterprise Business Solutions
    Geha Health Jun 2020 - Present
    Leeꞌs Summit, Missouri, Us
    Responsible for leading a team of Business/System Analysts, And Configuration Analyst for Facets Claims Processing system, Clinical Editing System and other ancillary systems.
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  • Unitedhealth Group
    It System Analyst Consultant
    Unitedhealth Group Feb 2015 - Jun 2020
    Us
    Responsible for leading the management and development of the prescriber data in the claims processing system. Provide direction to team members and operations partners regarding prescriber files. Manage vendor relationship with data source for prescriber validation.• Lead major clean-up of prescriber data that improved accuracy of processed claims data• Developed documentation of prescriber load process• Authored requirements for various projects including Medicare and Medicaid compliance initiatives
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  • Humana
    Program Manager
    Humana Sep 2008 - Feb 2015
    Louisville, Kentucky, Us
    Responsible for overseeing new technology design on dental and vision claims processing systems, writing business requirements, project plans, and test plans for implementations. Also responsible for the management of the Dental Product build, EDI and Reporting teams.• Key contributor in developing new CRM Module with Salesforce.com for Humana Specialty division• Re-designed front end matching on claims that improved auto-adjudication by an additional 7%• Developed a directional feed for misdirected claims from CompBenefits to Humana Systems which resulted in 2 FTE reduction• Successfully lead project to merge the Humana Dental PPO Network into the CompBenefits Claims Payment System• Developed a directional electronic claim feed for misdirected claims from Humana systems to CompBenefits systems• Designed claim feed to Humana's actuarial system that enables renewals on CompBenefits business on the Humana Systems• Lead a team of 10 associates for Quality Assurance on QicLink, AS400, and MDI Systems• Lead a team of 5 associates for EDI Claims tracking, System Support, and Plan Build
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  • Compbenefits
    Director, Technical Team And Training
    Compbenefits Mar 2005 - Mar 2008
    Us
    Responsible for managing the Plan Building team, EDI team, and all policies and procedures of the Claims Operation, training and development. • Project Manager for system upgrades and new technology on claims payment systems. Developed test plans and implementation schedules• Designed and implemented new technology that improved claims auto-adjudication rate by 12% in 2 years• Designed and implemented an automated process for submitting claims to two external review companies which eliminated manual intervention and improved efficiencies in claims and pre-screening• Designed and implemented an x-ray imaging system• Coordinated the implementation of the AutoDental and Dental Logic product in the Trizetto QicLink system• Developed and implemented an automated EDI process that automatically measures auto-adjudication and tracks inbound and outbound EDI processing• Successfully introduced and implemented 2 additional clearinghouses for electronic claims which increased EDI submissions from 35% to 62%
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  • Compbenefits
    Director Claims And Member Service
    Compbenefits 2003 - 2005
    Us
    Responsible for the management and daily operations of a claims staff of 3 claims processing teams and 2 member service teams. Also managed the training team. • Managed the development of an updated claims training program• Improved efficiencies in claims processing which assisted in being able to maintain existing targets with a 20% growth in business and no additional processing staff• Maintained all performance targets• Implemented new workforce management system to measure call volume, AHT and monitoring
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  • The Trizetto Group
    Senior Software Analyst
    The Trizetto Group Jul 2000 - Nov 2003
    Teaneck, Nj, Us
    Supported the QicLink and HIPAA Gateway systems to Trizetto key Clients. Assisting with software analysis, testing.Presented at Client ConferencesAssisted in software implementationConsulted in software enhancementsTested changes to software
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  • Compbenefits
    Audit Manager
    Compbenefits 1998 - 2000
    Us
    Responsible for leading the Audit and Training teams. Developed a new Audit process that fit with industry standards.Assisted in leading the implementation of EDI processing and automation of claims processing.
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  • Cna
    Claims Analyst
    Cna 1997 - 1998
    Responsible for Managing TPA relationships. Audited TPA's on claims payments. Investigated possible fraud.

Sonja Payne Skills

Health Insurance Process Improvement Insurance Training Managed Care Customer Service Medicare Management Strategic Planning Leadership Business Analysis Hipaa Team Building Employee Benefits Microsoft Excel Project Management Sdlc Healthcare Vendor Management Software Documentation Visio Microsoft Office Business Process Improvement Team Leadership Program Management Claim U.s. Health Insurance Portability And Accountability Act Analysis Claims Management Customer Relationship Management

Sonja Payne Education Details

  • Bradley University
    Bradley University
    Education
  • Huntington University
    Huntington University
  • Metamora
    Metamora

Frequently Asked Questions about Sonja Payne

What company does Sonja Payne work for?

Sonja Payne works for Geha Health

What is Sonja Payne's role at the current company?

Sonja Payne's current role is Mgr-Enterprise Business Solutions at GEHA Health.

What is Sonja Payne's email address?

Sonja Payne's email address is sp****@****ana.com

What is Sonja Payne's direct phone number?

Sonja Payne's direct phone number is +184799*****

What schools did Sonja Payne attend?

Sonja Payne attended Bradley University, Huntington University, Metamora.

What are some of Sonja Payne's interests?

Sonja Payne has interest in Unleashed Pet Rescue And Adoption, 247sports, Casey's Honeydo List Llc, Jill, Candace Payne, Amanda Bell #keepinitreal, Community, Cory Booker, Ava And Her 18 Royals, Blinds And Curtains Store.

What skills is Sonja Payne known for?

Sonja Payne has skills like Health Insurance, Process Improvement, Insurance, Training, Managed Care, Customer Service, Medicare, Management, Strategic Planning, Leadership, Business Analysis, Hipaa.

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