Alisha Lewis
Fort Worth,United States
Summary
Efficient Claims Processor known for high productivity and task completion. Possess specialized skills in claims analysis, documentation verification, and regulatory compliance ensuring smooth operation flow. Excel in time management, problem-solving, and communication, leveraging these soft skills to effectively manage workloads and facilitate clear interactions with all stakeholders.
Overview
11
11
years of professional experience
Work History
Claims Processor
United Healthcare
Fort Worth
03.2024 - 12.2025
- Efficiently processed claims utilizing proprietary software systems.
- Scrutinized documentation to ensure adherence to healthcare regulations.
- Liaised with providers to resolve claim discrepancies and inquiries, ensuring timely and accurate claim resolution.
- Analyzed claims data for accuracy and completeness prior to submission.
- Facilitated onboarding and training of new staff on claims processing procedures, enhancing team readiness and knowledge.
- Managed a high volume of incoming claims in alignment with established policies and procedures.
- Executed claims processing according to quality and production standards, correcting and adjusting claims to ensure compliance.
- Maintained strict adherence to all applicable laws, regulations, and company standards throughout claims processing.
- Coordinated benefits with medical insurance plans and Medicare providers.
- Applied knowledge of coding systems, including CPT-4 and HCPCS codes, to ensure proper reimbursement.
- Collaborated with healthcare providers to resolve discrepancies in claims.
Direct Support Professional
Holy Angels, Inc.
Shreveport
12.2018 - 06.2020
- Provided essential assistance to individuals with daily living activities and personal care requirements.
- Supported clients in their engagement with community resources and recreational activities.
- Implemented individualized care plans specifically tailored to meet each client's unique needs.
- Monitored and meticulously documented client progress and observed behavioral changes.
- Trained new team members on best practices for direct support techniques.
- Ensured a safe and secure environment by strictly following health and safety protocols.
- Delivered direct care to individuals with intellectual and developmental disabilities, fostering independence in activities of daily living.
- Offered assistance to individuals with daily tasks, including personal care, meal preparation, and medication reminders.
Call Center Representative
Teleperformance
Shreveport
10.2014 - 07.2017
- Managed high call volumes effectively while consistently ensuring a positive customer experience.
- Utilized call center software to log interactions and track customer requests, ensuring accurate records for future reference.
- Guided customers in navigating products and services to ensure optimal utilization.
- Utilized call center software to accurately log interactions and track customer requests.
- Documented customer feedback to identify trends and inform product improvements and service enhancements.
- Updated customer accounts, addresses, and contact information in call management databases to maintain accurate customer records.
Education
High School Diploma -
Susan Miller Dorsey High School
Los AngelesSkills
- Claims processing
- Claims adjudication
- Claims auditing
- Claims review
- Claim coding
- Policy adherence
- Documentation management
- Data analysis
- Healthcare regulations
- Accuracy and precision
- Attention to detail
- Problem solving
Timeline
Claims Processor
United Healthcare
03.2024 - 12.2025
Direct Support Professional
Holy Angels, Inc.
12.2018 - 06.2020
Call Center Representative
Teleperformance
10.2014 - 07.2017
High School Diploma -
Susan Miller Dorsey High School