Seasoned Claims Processor evaluating online entry, error correction and quality control review for final adjudication of claims. Strong business and financial acumen with proven success to maintain efficient operations. Extensive knowledge of billing, collections and fiduciary management.
Overview
6
6
years of professional experience
Work History
Claims Processor
Amgen Applied Molecular Genetics
Remote
10.2024 - Current
Maintained accurate records of all processed claims in accordance with departmental requirements.
Performed quality assurance reviews on completed work to ensure compliance with standards.
Processed a high volume of incoming claims in accordance with established policies and procedures.
Researched discrepancies between submitted documentation and actual records to identify errors or omissions.
Updated job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations .
Processed paperwork associated with approved claims payments.
Intake Specialist
Highmark Wholecare
Remote
04.2022 - 11.2023
Documented all patient contact activities in accordance with agency standards and regulations.
Maintained accurate records of all client interactions according to agency policies and procedures.
Reviewed referral sources for appropriateness prior to admission into program.
Offered additional products or services to enhance customer experience.
Maintained detailed records of customer interactions and transactions for future reference.
Conducted audits of call center agents' interactions with customers for quality assurance purposes.
Assistant Manager
CoreLife Eatery
Pittsburgh
01.2019 - 04.2020
Provided guidance and support to junior staff members on daily tasks, projects, and objectives.
Organized training sessions for new hires to familiarize them with the workplace environment.
Conducted regular performance reviews for employees to identify areas of improvement.
Developed a system for tracking inventory and ordering supplies as needed.
Coordinated with other departments to ensure smooth flow of operations.
Maintained accurate records of sales transactions using point-of-sale systems.
CERTIFIED CLINICAL RESEARCH COORDINATOR at Department of Medical and Molecular Genetics at Indiana University School of MedicineCERTIFIED CLINICAL RESEARCH COORDINATOR at Department of Medical and Molecular Genetics at Indiana University School of Medicine