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Skills

  • Budgets
  • Fraud detection
  • Audit preparation
  • Claims tracking system deployment
  • Process equipment
  • Problem resolution
  • Data Analysis for Performance Metrics
  • Process improvement
  • Relationship development
  • Customer service

Work Experiences

  • Achieved a 37% claim accuracy rate.
  • Consistently met deadlines.
  • Collaborated with the accounting department.
  • Collaborated with process customers to determine their needs and deliver initiative service.
  • Transported Tableau to several months customer locations.
  • Achieved timely completion every 2019.
  • Had an excellent attendance record and was always on time for work.
  • Collaborated with IT to optimize the digital claims submission platform, reducing submission errors by 33%.
  • Collaborated with cross-functional teams to resolve complex claim discrepancies, resulting in a 13% reduction in aged claims.
  • Collaborated with IT to optimize the digital claims submission platform.

Summaries

  • Listening to customers, meeting productivity goals, and staying current on company offerings are all skills she possesses.
  • Costs were consistently reduced while profits were increased.
  • Collaborated with cross-functional teams.
  • Claims Processing Clerk with 16 years of successful project management and stakeholder engagement experience.
  • Adhered to strict compliance standards.
  • Strengths in process improvement and quality assurance backed up by Miscellaneous training.
  • Claims Processing Clerk with 11 years of experience, dedicated to providing personalized, courteous service.
  • Claims Processing Clerk is a multi-talented Claims Processing Clerk who is consistently rewarded for planning and operational improvements.
  • Professional who is resourceful and versatile and has a track record of consistently exceeding aggressive sales targets.
  • Effective at managing phone calls, emails, letters, and in-person requests for assistance while adhering to framework regulations and standard department guidelines.

Accomplishments

  • Collaborated with IT and operations teams to automate claims entry processes, reducing manual input errors by 18%.
  • Assessed claims documentation for completeness and accuracy, consistently meeting or exceeding quality benchmarks by 21%.
  • Resolved a backlog of 9 claims by implementing a streamlined workflow, reducing processing times by 63%.
  • Implemented process improvements that reduced average claims handling time from 11 days to 4 days.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Assumed responsibility for the filing and organization of over 4 claims weekly, ensuring timely delivery of information to appropriate teams.
  • Contributed to cross-functional task forces to design and roll out new claims adjudication protocols across multiple sites.
  • Facilitated cross-functional team meetings to align claims processing goals and improve departmental communication.
  • Reviewed an average of 7 claims daily, identifying discrepancies to ensure timely approvals and avoid claim rejections.
  • Led a database migration project, increasing accuracy of claims data by 67% and reducing duplication by 26%.

Affiliations

  • Association for Supply Chain Management (APICS)
  • International Association of Administrative Professionals
  • International Council of Nurses
  • International Medical Claims Assistance Association (IMCAA)
  • Insurance and Financial Communicators Association (IFCA)
  • Jaycees
  • Institute of Certified Professional Managers (ICPM)
  • Risk Management Society (RIMS)
  • Association of Information Technology Professionals
  • American Association of Medical Assistants (AAMA)

Certifications

  • Medical Billing and Coding Certification, Harbor & Co., 2016
  • Certified Professional Coder (CPC) – Ironclad Systems, 2017
  • Certified Business Analysis Professional (CBAP)
  • Health Insurance Specialist Certification - Harbor & Co., 2024
  • CompTIA Network+
  • Certified Employee Benefits Specialist (CEBS)
  • CompTIA A+ Technician
  • Lean Certification for Insurance Operations
  • Certified in Healthcare Compliance (CHC)
  • AAPC Healthcare Compliance Certification

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