Kiera Milton
Atlanta
Summary
Detail-oriented Claims Coordinator with 4 years of experience in claims processing, adjudication, and adjustments. Skilled in reviewing, analyzing, and resolving claims efficiently while ensuring compliance with policies and regulations. Adept at data entry, documentation, and collaborating with internal teams to streamline claims processing. Seeking to leverage expertise in claims adjudication to transition into a Claims Processor role.
Overview
7
7
years of professional experience
1
1
Certification
Work History
NSA Claims Coordinator
MultiPlan
02.2024 - Current
- Adjudicate claims and process adjustments, ensuring accuracy and compliance with company policies and regulations.
- Review and analyze claim submissions, identifying discrepancies and resolving issues in a timely manner.
- Provided guidance and assisted team members on challenging cases during high workload periods.
- Ensured accurate documentation by maintaining and updating claim records through the use of reference materials.
Medical Telescribe
ScribeAmerica
07.2022 - 02.2024
- Collaborated with healthcare providers to optimize the integration of telehealth technology into medical documentation processes
- Conducted real-time medical documentation during telehealth appointments, ensuring comprehensive and accurate records
- Implemented efficient workflow processes to enhance productivity and maintain high quality standards
- Followed all HIPAA rules and regulations regarding patient confidentiality
Grievance Coordinator
CVS Health
08.2020 - 07.2022
- Managed and investigated member grievances, collaborating with internal teams to address and resolve issues promptly
- Processed and adjudicated claims, ensuring accuracy and compliance with healthcare regulations
- Maintained accurate records and documentation of grievance processes to ensure compliance with regulatory requirements
- Coordinated communication between members, providers, and internal departments to facilitate resolution and prevent recurrence
Supervisor
C&C Market Research
04.2018 - 03.2020
- Supervised and coordinated research teams to gather and analyze market data
- Provided excellent customer service, addressing inquiries and resolving concerns related to market research studies
- Designed and executed primary research methodologies, including surveys, focus groups, and interviews to gather relevant data
- Entered data into databases and spreadsheets, verifying, and cross checking information for completion and accuracy
Education
Bachelor Of Computer Science -
Georgia State University
Atlanta, GASoftware Development -
Southern Careers Institute Inc
Austin, TX07.2023
Skills
- Claims Processing & Adjudication
- Adjustments & Resolutions
- Policy & Compliance Review
- Documentation & Data Entry
- Customer Service & Support
- Collaboration
- Strong Attention to Detail
- Medical Terminology
- Medical Procedures
- Adaptability
- Learning New Technologies
- Learning New Protocols
- Time Management
- Organizational Skills
- Problem Solving & Analytical Skills
Certification
Licensed Software Developer, 07/23
Timeline
NSA Claims Coordinator
MultiPlan
02.2024 - Current
Medical Telescribe
ScribeAmerica
07.2022 - 02.2024
Grievance Coordinator
CVS Health
08.2020 - 07.2022
Supervisor
C&C Market Research
04.2018 - 03.2020
Bachelor Of Computer Science -
Georgia State University
Software Development -
Southern Careers Institute Inc
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