
Dynamic professional with a strong foundation in communication and organizational skills, adept at identifying innovative solutions and leveraging analytical expertise to achieve impactful results. Demonstrated excellence in fast-paced environments while managing multiple tasks and priorities effectively. Proficient in facilitating group discussions and leading projects to successful completion, fostering collaboration and driving team success. Committed to continuous improvement and delivering exceptional outcomes through strategic planning and execution.
Provides authentic details to the insurance agent and helps patients with the settlements, checks eligibility, and verifies benefits. Reviews patient bills for accuracy, completeness, and obtains any missing information. Knowledge of insurance guidelines, including HMO, Medicare, and state Medicaid. Checks insurance payments for accuracy and compliance with contract discounts. Handling and processing the claim for durable medical equipment. Perform audits of pending claims. Communicated with insurance carriers to verify patient insurance eligibility and benefits. Implemented timely billing and claim submissions to insurance providers. Perform assigned duties beyond expectations to maintain high professional and personal standards, and ensure absolute satisfaction with the work produced. Supporting month-end closing activities of the team to reach targets. I worked as a data analyst for a healthcare project. Screening the application of the client's information for verifying and validating the application with internal tools, with 100% quality and processing for billing. Records and tracks of incoming cases via the utilization of the database. Audit the case for completeness after internal submission. Identify and collect additional information from the external agent and internal client through e-mail. Validating the application and delivering it to the client with high quality.
Roles and Responsibilities:
Customer relations
Communication skills
Leadership
Time management
Customer-focused
Claim processing
FACETS application
HIPAA compliance
Healthcare operations
Quality assurance
Training and mentoring
Audit coordination
Effective communication
Team player
Motivation
Partnership building
ACE OF ROOKIES