Adrienne Watkins
Birmingham,AL
Summary
Service-oriented Analyst with 20 years background in healthcare and 6 in Auto claims. Core competencies include claims, recovery and billing as well as excellent communication and time management skills. Handles tasks with accuracy and efficiency.
Overview
28
28
years of professional experience
1
1
Certification
Work History
Claims Adjuster/Subrogation Specialist
Kemper Auto Insurance
Birmingham, AL
01.2020 - Current
- Evaluated and processed claims to ensure compliance with policy terms and conditions.
- Conducted thorough investigations of claims, identifying discrepancies and mitigating potential fraud risks.
- Reviewed complex claims cases, providing expert recommendations for settlements based on industry standards and regulations.
- Examined claims forms and other records to determine insurance coverage.
- Verified insurance claims and determined fair amount for settlement.
- Maintained compliance with state regulatory requirements through meticulous documentation and adherence to company policies.
- Conducted thorough investigations of complex insurance claims, gathering evidence and analyzing relevant documentation.
- Achieved cost savings through successful subrogation efforts, recovering funds from responsible parties in various claims scenarios.
- Prepared summaries of damage, payments, and policy coverage.
- Provided exceptional customer service during emotionally difficult situations for policyholders following accidents or natural disasters.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Answered customer questions regarding deductibles.
- Evaluated coverage accurately by interpreting complex insurance policies and applying them to specific claims.
- Improved claim resolution times by efficiently managing a caseload of 50+ claims per month.
- Identified potential fraud indicators early in the investigation process, protecting company assets from potential losses due to fraudulent activity.
- Reduced processing time for property damage claims by accurately assessing repair costs and negotiating with contractors.
- Provided exceptional customer service, addressing concerns, and answering questions promptly.
Recovery Specialist II
Lydian
Birmingham, AL
07.2013 - 10.2019
- Process recovery of Medicare funds from insurance companies and third party agencies.
- Responsible for all duties involved with the follow-up and prompt collections of patient balances on Government, Managed Care, Commercial and Worker's Compensation account balances.
- Respond to customer inquiries, problems or complaints in a courteous and professional manner.
- Performs follow-up functions on rejected and disputed claims.
- Request medical record documentation as required to resolve disputes on the account.
- Assist patients with billing concerns.
- Documents all accounts clearly and concisely of all patient, attorney, insurance carrier activity and resolve all accounts through final collections.
- Answers patient billing questions promptly and courteously.
- Led two training classes within a year and a half of starting.
- Formerly Cahaba Government Administrators
Patient and Billing Coordinator
East Alabama Homemed LLC
Opelika, AL
10.2009 - 12.2012
- Serve as point of contact to patients, referral source, and liaison between patient and delivery staff.
- Reviewing all submitted documentation to ensure patients qualify, per insurance guidelines, equipment requested.
- Accurate insurance verification, obtaining PA's.
- Relaying in a timely manner, estimated customer share to patient's (caregiver/POA).
- Assist respiratory therapist with set-up of CPAP/BIPAP'S.
- Certified in fitting Respironics, Fisher & Paykel, and Resmed masks.
- Manage and deliver CMNs to physicians in an expeditious time frame.
- Responsible for obtaining and relaying current Medicare/ Medicaid updates.
- All other duties as assigned.
Patient and Billing Coordinator
Midsouth Gentiva Health Services
Birmingham, AL
03.2008 - 10.2009
- Serve as first point of contact to patients and referral source.
- Maintain patient confidentiality, serve with respect, honesty, and provide quality patient care services.
- Proactive in timely input, logging, and delivery of patient equipment.
- Accurate insurance verification and obtaining PA's.
- All other duties as assigned.
Assistant Account Representative
Medquist Transcriptions Ltd
Mount Laurel Township, NJ
02.2006 - 12.2007
- Served as Liaison between Clients and Vendor.
- Provided physicians and staff with adequate training on dictation equipment and software.
- Also provided Q-care services, which is correcting any transcription error.
- Set up auto transcription documents for multiple physicians.
- All other duties as assigned.
Radiology Unit Clerk
Children's of Alabama
Birmingham, AL
08.1998 - 02.2006
- Responsible for training new clerks on the hospital's radiology system (Magic Web/PACS), radiology procedures, and patient registration process.
- Responsible for digitizing all nuclear medicine, ultrasound, CT, MRI and diagnostic exams.
- Works closely with radiologists, physician offices, and parents ensuring that they receive excellent customer service.
- Responsible for peer review with radiologist which includes reviewing patient's medical records.
Education
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Strayer University
Birmingham, ALSkills
- Research
- Claims Handling (Auto & Medical)
- Teaching
- Communication
- Healthcare
- Written Communication
- Verbal Communication
- Interpersonal Communication
- Medical Terminology
- ICD-9 Coding
- ICD-10 Coding
- Insurance Verification
- HIPAA Compliance
Certification
Licensed Adjuster
Timeline
Claims Adjuster/Subrogation Specialist
Kemper Auto Insurance
01.2020 - Current
Recovery Specialist II
Lydian
07.2013 - 10.2019
Patient and Billing Coordinator
East Alabama Homemed LLC
10.2009 - 12.2012
Patient and Billing Coordinator
Midsouth Gentiva Health Services
03.2008 - 10.2009
Assistant Account Representative
Medquist Transcriptions Ltd
02.2006 - 12.2007
Radiology Unit Clerk
Children's of Alabama
08.1998 - 02.2006
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Strayer University