Mya Malcom
GRIFFIN
Summary
Detail-oriented professional driven to resolve claims fairly while representing interests of employer. Conducts thorough and informed investigations, precisely evaluates losses and negotiates settlements that satisfy diverse parties. Builds and maintains professional and productive relationships and works to understand potentially conflicting points of view.
Overview
5
5
years of professional experience
2018
2018
years of post-secondary education
Work History
Claims Specialist,
Lab Corp
GRIFFIN
11.2024 - Current
- Manage a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills
- Enhance customer satisfaction with timely communication, empathy, and clear explanations of claim outcomes
- Develop strong working relationships with external partners such as adjusters, legal counsel, and medical professionals to facilitate efficient claim resolution processes.
- Settle complex claims fairly by applying critical thinking, negotiation skills, and detailed knowledge of insurance policies.
Medical Claims Specialist,
WellStar
Griffin
01.2023 - 08.2024
- Reduced errors in claims submissions through meticulous attention to detail and thorough review pro
- Negotiated payment plans for patients facing financial hardships, minimizing revenue loss while mai empathetic customer service.
- Improved claim processing efficiency by streamlining workflows and implementing best practices.
- Managed high volume of claims, consistently meeting deadlines without compromising accuracy or quality.
Medical Transportation Appointment
Modicare
Griffin
02.2021 - 12.2022
- Provided excellent customer service through attentive listening, empathetic communication, and efficient problem-solving during the scheduling process.
- Answered phone calls and answered questions from potential customers.
- Managed high call volume while maintaining professionalism and accuracy when gathering client information for appointment bookings.
- Acted as first point of contact and set appointments for prospective clients.
Education
Henry County High School
McDonough, GASkills
- Claims
- Claims Processing
- Claims Investigation
- Verbal Communication
- Compliance Management
- ICD-10 Proficiency
- HIPAA knowledge
- Medicare Expertise
- Healthcare compliance
- Medicaid knowledge
- Claim Denials Management
- EOB Analysis
- Excellent administrative abilities
- Patient Rapport
Timeline
Claims Specialist,
Lab Corp
11.2024 - Current
Medical Claims Specialist,
WellStar
01.2023 - 08.2024
Medical Transportation Appointment
Modicare
02.2021 - 12.2022
Henry County High School