Jamerria Hill
Loganville
Summary
Detail-oriented professional with strong proficiency in ICD-10 coding, claims processing, and HIPAA compliance. Proven ability to resolve complex claim issues and enhance efficiency through process improvements.
Overview
8
8
years of professional experience
Work History
Medical Claims Processor (Non Phone WFH)
Sutherland Global
Loganville, GA
09.2024 - Current
- Processed medical claims with a focus on accuracy and compliance with industry regulations.
- Reviewed and analyzed claim submissions to identify discrepancies and ensure timely resolution.
- Collaborated with healthcare providers to clarify information and expedite claim processing.
- Trained new team members on claims processing protocols and system usage.
- Researched and resolved complex medical claims issues to support timely processing.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Verified patient insurance coverage and benefits for medical claims.
- Managed large volume of medical claims on daily basis.
Healthcare Claims Specialist (Temp WFH)
Robert Half
Lawrenceville Ga
10.2023 - 05.2024
- Evaluated claims for accuracy and compliance with company policies and regulations.
- Facilitated communication between clients and insurance providers to resolve issues promptly.
- Analyzed complex claims data to identify trends and recommend process improvements.
- Mentored junior staff on best practices for claims processing and customer service excellence.
- Enhanced customer satisfaction with timely communication, empathy, and clear explanations of claim outcomes.
Medical Claims Processor
Children's Healthcare of Atlanta
Cumming, GA
06.2022 - 10.2023
- Reviewed and processed medical claims to ensure accuracy and compliance with healthcare regulations.
- Collaborated with healthcare providers to resolve discrepancies in claims submissions promptly.
- Analyzed claim data to identify trends and recommend process improvements for efficiency.
- Trained new team members on claims processing procedures and system navigation.
- Improved claim processing efficiency by conducting thorough reviews of medical claims and identifying discrepancies.
- Generated reports on medical claims processing activities and results.
- Managed a high volume of medical claims by prioritizing tasks based on due dates and urgency, preventing delays in processing.
Medical Claims Specialist (WFH)
Kaiser Permanente
Duluth, GA
03.2018 - 06.2022
- Processed medical claims with high accuracy, ensuring compliance with regulatory standards.
- Reviewed and resolved claim discrepancies, collaborating with healthcare providers for clarification.
- Utilized electronic health record systems to streamline claims processing and documentation retrieval.
- Implemented process improvements that reduced processing time and enhanced overall efficiency.
- Utilized advanced knowledge of ICD-10 codes to accurately process complex medical claims.
- Conducted regular audits of processed claims to identify areas for improvement and potential fraud risks.
Education
High School Diploma -
Penn Foster College
Scottsdale, AZBBA -
Strayer University
06-2027
Skills
- ICD-10-cM coding
- Customer service
- Claim denial resolution
- HIPAA compliance awareness
- Claims processing proficiency
- Insurance claims processing
- Professionalism and ethics
- Medical Terminology Familiarity
- CPT code mastery
- Electronic claims processing
- Critical Decision-making
- Provider relations
Timeline
Medical Claims Processor (Non Phone WFH)
Sutherland Global
09.2024 - Current
Healthcare Claims Specialist (Temp WFH)
Robert Half
10.2023 - 05.2024
Medical Claims Processor
Children's Healthcare of Atlanta
06.2022 - 10.2023
Medical Claims Specialist (WFH)
Kaiser Permanente
03.2018 - 06.2022
High School Diploma -
Penn Foster College
BBA -
Strayer University