Subject Matter Expert and trusted advisor skilled in research, analysis and examination of company technology and standard operating procedures. Interface and collaborate with clients and internal team members, providing consultative enhancement recommendations based on industry research. Improve existing processes, procedures, technical enhancements, resource requirements, and stakeholder engagement procedures to align with strategic goals.
Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
Certified processor for processing “U.S Health Care Claims” by logging through Main frame system of Citrix application and adjudication the claims in “Customer-Server”. Claim is pulled by Ultra application and processed by Facets application
Healthcare Industry Knowledge