Claims Analyst reviewed and prcessed medical claims. Customer service
- Claims Analyst at CoreSource
- Claims Analyst at Presidium
18 years at this Job
- Some college
- High school
A claims analyst monitors liability claims from start to finish, verifying and updating information on submitted claims, reviewing the policy to determine which charges are eligible for reimbursement, reconciling a claims adjuster's estimates, negotiating payment to all parties and following up to ensure that payments are made. Making sure all necessary information is correct to submit payments.
- CLAIMS ANALYST at HealthSCOPE Benefits, Inc.
- MEDICAL BILLING SPECIALIST at Arkansas Urology
- COMMERCIAL INSURANCE SPECIALIST at Advanced Tissue
1 year, 8 months at this Job
- No Degree-Completed Core Curriculum - GENERAL STUDIES
• I am currently a Claims Analyst.
• I have had the opportunity to work on several different medical billing platforms.
• I have also had the opportunity to analyze medical claims and figure out the best way to correct any billing errors to get insurance to pay.
- Claims Analyst at Greenway Health
- Substitute Teacher at Kelly Services
- Medical Billing Specialist/Administration at Solutions Community Services, Inc
- Substitute Teacher at County Child Center
3 years, 8 months at this Job
Basic and Advance claims Analyst. Working on various pends that will stop a claim from processing correctly. A member of the transplant team; searching through contracts in order to make sure claims are paying at the correct percentage based on provider contracts.
- Claims Analyst at Centene
- Owner/Operator at Stitch Me Up Good
- Lyft Driver at Lyft
- Delivery Driver at Instacart
1 year, 1 month at this Job
- Associate - General Studies
Dedicated claims analyst for several high-profile universities, including Temple University and the University of Pennsylvania Attend high exposure mediations and settlement conferences Present claims to senior management to obtain appropriate reserve authority Successfully manage caseload in excess of 250 claims Prepare coverage evaluation letters for Insureds
- Claims Analyst III, Employment Litigation at AMERICAN INTERNATIONAL GROUP (AIG) CLAIMS, INC
- Law Clerk to Partner Ronald P. Goldfaden at BLUME GOLDFADEN
- Extern at NEW JERSEY OFFICE OF THE ATTORNEY GENERAL
- Research Assistant for Professor Tara A. Ragone at SETON HALL UNIVERSITY SCHOOL OF LAW
4 years, 5 months at this Job
- Juris Doctor
• Developed a solid understanding of assigned client's process in order to strategically review and analyze their A/R functions
• Conducts regular audits of Insurance follow up team's claim work for accuracy and quality
• Manages clean claim ratios for assigned clients
• Provides direction to Client Leads on claim audit corrections and resolution
• Prepares and analyzes reports of audit reviews and performance issues with a focus on identifying trends, instituting continuous quality improvement initiatives, and identifying and providing on-going training opportunities for clients and third party vendors
• Provides second-tier review on advanced and escalated claim issues to a satisfactory resolution
• Resolves outsourced vendor's escalations of claims and claim rework
• Logs all client issues encountered in internal tracking system, including enhancement requests, bugs, errors, and inquiries.
• Modifies processed and procedures to prevent claim rework through automation ideas
• Billed medical claims for several client's to include ENT, General Practice, and OBGYN
- Claims Analyst at Greenway Health Inc
- Provider Contact Center Representative at Cahaba Government Benefit Administrators
- DBA Anderson Mill Health and Rehab at Sava Senior Care
- Customer Service Representative II at Anthem Blue Cross Blue Shield
11 months at this Job
- High school
Senior Claims Analyst
Processing & Adjusting Medical/Hospital claims on AMYSIS through on-line adjudication.
• Ability to maintain quality and production
• Verify Provider authorizations/credentials
• Provide issue resolution
- Medical Claims Analyst II at NTT DATA Services
- High School Teacher at Clara B. Ford Academy
- Senior Claims Analyst/ Xcelys at Dell Inc
- Plato Credit Recovery On-Line Facilitator / I.T. Coordinator at Clara B. Ford Academy & Vista Meadows Academy
1 year, 10 months at this Job
- Masters - Career and Technical Education
- Bachelor of Arts
- Associates of Arts - Business Adm
Certified Professional Billing Claims Analyst. Worked with the billing office (on the IS side) to keep workflows moving and up-to-date. Epic certifications include:
• PB Claims
• PB Remittance
• HB Claims
• HB Remittance
• HB SBO Fundamentals
• PB SBO Fundamentals
• PB SBO Admin
- Epic PB Claims Analyst at Wellmont Health Systems
- Summer Internship - Accounting Intern at Alpha Natural Resources
- Cashier / Bagger at Food City
- Team Member at Pal's Sudden Service
2 years, 2 months at this Job
- Bachelors of BBA in Finance - Corporate Finance & Investments
I am a full time claims analyst and biller for WRMC. My experience includes workers compensation, and all insurance companies of various sizes (Ambetter, Qualchoice, BCBS, Aetna, Cigna, UHC, PHCS/Multiplan, First health Network plans, etc) I verify insurance, bill out claims, contact patients and insurance companies to get claims paid. I have active use of fax/copiers, computer and telephone.
- Claims Analyst and Biller at Washington Regional Medical Ctr
- Weekend Hotel Manager-Front Desk at Fairfield Inn
- Medical Appeals Coordinator/Claims Specialist at United HealthCare Inc
- Night audit and Bookkeeper at ZMC Hotels/Inn
4 years, 9 months at this Job
- A.A.S. degree - Business Administration
• Responsible for full range of professional medical claims for Asbestos.
• Verify all medical/exposure billings for reasonable and necessary charges.
• Provided Review of claims which law firms questioned about appropriateness of payments authorized.
• Evaluated claims referred for medical and exposure for further investigation/documentation as necessary.
• Establish channels of communication with law firms to familiarize them with agency rules.
• Assist and advises other analysts concerning the monitoring claims for exposure to Asbestos.
• Perform Project Assignments when necessary.
- Claims Analyst at Claims Resolution Management Corporation
- Billing Audit/Rep I at Medstar Washington Hospital Center
- Billing Manager/ Customer Service at Cignet Health Center
- Lead Teacher at
5 years at this Job