Debbie Stimac
Sugar Grove
Summary
Results-driven professional with extensive experience at Cigna Healthcare, excelling in claims processing and customer service. Proven ability in CRM management and multi-channel communication, consistently exceeding departmental goals in accuracy and productivity. Recognized for strong problem-solving skills and attention to detail, enhancing operational efficiency and client satisfaction.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Appeals Specialist
Allied Benefit Systems
Chicago
06.2025 - Current
- Monitoring and tracking of Medical Claim Appeals
- Uses multiple systems on dual monitors to navigate and investigate effectively
- Reviewing Summary Plan Description to determine the validity of the appeal.
- Documenting Qiclink database with appeal status and outcome
- Composing appeal responses as needed
- Prioritize incoming referrals to complete all responsibilities timely
- Communicate responses to business partners and other departments
Service Operations
MultiPlan
Naperville
03.2024 - 06.2025
- Managed high volumes of incoming and outgoing correspondence, ensuring timely and accurate distribution to relevant departments.
- Processed payments, scanned, and uploaded documents, maintaining detailed records of subrogation cases.
- Utilized Excel to track and inventory incoming mail, ensuring accurate reporting and meeting monthly performance goals.
- Collaborated with team members using Microsoft Teams for communication and updates on case progress.
- Exceeded monthly goals set by management, consistently meeting or exceeding performance targets.
Business Owner
Don’t Sweat It Customs, LLC
Plainfield
07.2017 - 01.2023
- Coordinated custom orders for clients, managed vendor relationships, and handled booking and scheduling of orders.
- Delivered exceptional customer service through multiple communication channels (email, text, phone), ensuring customer satisfaction and on-time deliveries.
- Managed a customer service inbox, responding to up to 50 inquiries daily, providing fast solutions to requests, and offering personalized product recommendations.
- Implemented systems for order tracking, inventory management, and billing, ensuring high accuracy and customer satisfaction.
- Exceeded sales goals and doubled revenue in the second year through effective marketing and customer relationship management.
Senior Claims Advocate/Appeals
Cigna Healthcare
05.2011 - 07.2017
- Processed and reviewed complex claims, ensuring compliance with HIPAA guidelines and internal policies.
- Provided exceptional customer service through phone, email, and electronic systems, resolving claims issues and inquiries.
- Assessed customer needs by actively listening and providing tailored solutions for claims and appeals, ensuring accurate processing and resolution.
- Investigated and resolved claims appeals, collaborating with providers and third-party administrators (TPAs) to adjust claims and resolve issues.
- Maintained accurate records of all claims, appeals, and customer interactions, ensuring compliance with company policies and industry standards.
- Trained new employees, mentored team members, and contributed to the improvement of team processes, resulting in reduced errors and increased efficiency.
- Exceeded departmental goals in accuracy, productivity, and customer satisfaction.
Education
Associate of Science - Business Management
Joliet Junior College
Joliet, ILSkills
- CRM and database management
- Multi-channel communication
- Microsoft Office Suite
- Claims and insurance systems
- Data entry and documentation
- Customer service excellence
- Attention to detail
- Time management and multitasking
- Problem solving
- Collaboration
- Flexibility and adaptability
Certification
Pharmacy Technician Certification, Illinois, 2023
References
Available upon request
Additional Information
Highly adaptable to remote work environments, successfully managing work-life balance while maintaining productivity., Successfully led teams to exceed sales and customer satisfaction goals, fostering collaboration and positive team dynamics., A dedicated, self-motivated professional with a proven track record of meeting deadlines and exceeding performance expectations.
Timeline
Appeals Specialist
Allied Benefit Systems
06.2025 - Current
Service Operations
MultiPlan
03.2024 - 06.2025
Business Owner
Don’t Sweat It Customs, LLC
07.2017 - 01.2023
Senior Claims Advocate/Appeals
Cigna Healthcare
05.2011 - 07.2017
Associate of Science - Business Management
Joliet Junior College