Kristen Davis
Sandy Springs,GA
Summary
Detail-oriented Claims Adjuster with hands-on experience reviewing, adjusting, and resolving claims accurately and efficiently. Brings a strong foundation in document control, ensuring compliance, organization, and precise handling of sensitive records. Known for strong analytical skills, attention to detail, and the ability to thrive in fast-paced, regulated environments.
Overview
9
9
years of professional experience
Work History
Claims Adjustor
Wipro
08.2023 - Current
- Determine claim approval based on policy coverage, eligibility, and medical documentation.
- Knowledge of Medicaid, Medicare Part A & B, Dental and Medical; New Day and adjustments.
- Correct errors such as DOS, member/provider information, missing authorizations, duplicate claims and enrollment or termination dates.
- Ensure claims align with procedure codes (ICD-10, CPT, HCPCS) insurance regulations and state laws.
- Investigate denials or rejected claims by gathering additional documentation and appealing when necessary.
QA Document Control Administrator
Avanos Medical
06.2017 - 07.2023
- Completed admin reviews for new review/revision details, comments regarding updates or status changes, version control, and the possibility to obsolete a drawing.
- Maintained and organized company documentation, including standard operating procedures (SOPs), work instructions, quality records, and employee user credentials and training.
- Game Ready® Migration, oversaw supplier integration, vendor management, data flow and post launch activities of 30+ companies.
- Worked cross-functionally with regulatory, legal, and procurement, along with international manufacturing work sites.
- Designated internal teams, conducted mock drills, and organized QMS documents for internal/external audits, including FDA and ISO audits.
- Organized regulated documentation (digital and physical) and executed periodic inventories for preservation activities.
Skills
- Operations/Project Management
- FDA Audits
- Organizational Development
- Business Process Development
- Complex Problem Solving
- Supplier Management
- Performance Metrics and KPI's
- Multichannel Communication
- Remote Collaboration Tools
Timeline
Claims Adjustor
Wipro
08.2023 - Current
QA Document Control Administrator
Avanos Medical
06.2017 - 07.2023