Experienced with handling customer interactions and resolving issues promptly. Utilizes communication and empathy to build strong customer relationships. Track record of maintaining high customer satisfaction and fostering loyalty.
Overview
9
9
years of professional experience
Work History
Insurance Verification Specialist
RemX, McKesson Specialty
09.2024 - 01.2025
Conducted thorough insurance verifications to ensure accurate patient coverage and minimize claim denials.
Collaborated with healthcare providers to obtain necessary documentation for timely processing of claims.
Implemented process improvements resulting in enhanced efficiency and reduced verification turnaround times.
Trained new staff on verification protocols and best practices, fostering a knowledgeable team environment.
Ensured compliance with HIPAA regulations while managing sensitive patient information during the verification process.
Medical Records Audior
RemX Specialty Staffing
03.2023 - 02.2024
Conducted thorough audits of medical records to ensure compliance with regulatory standards.
Identified discrepancies in patient documentation and recommended corrective actions for improvement.
Utilized electronic health record (EHR) systems to maintain data integrity and facilitate efficient audits.
Assisted in the development of training materials for staff on proper documentation practices.
Collaborated with healthcare providers to improve documentation practices, enhancing overall quality of care.
Trained new staff on medical records auditing procedures, ensuring consistency across all team members.
Workers Compensation Claims
Sedgwick CMS
09.2019 - 10.2023
Consulted with attorneys on malpractice, personal injury and workers compensation claims.
Supported team cohesion by fostering open communication among coworkers, management, and dispatch personnel.
Reduced company costs by identifying fraudulent claims and recommending appropriate actions to prevent future occurrences.
Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
Prepared persuasive demand letters for insurance claims settlements, securing fair compensation for clients.
Provided support for workers'' compensation claims processing, resulting in faster resolution times and improved employee satisfaction.
Express Scripts
Teleperformance
06.2016 - 08.2019
Worked well in a team setting, providing support and guidance.
Assisted with day-to-day operations, working efficiently and productively with all team members.
Proven ability to learn quickly and adapt to new situations.
Excellent communication skills, both verbal and written.
Worked effectively in fast-paced environments.
Self-motivated, with a strong sense of personal responsibility.