Aliyah Shakir
Lithonia ,GA
Overview
2027
2027
years of professional experience
Work History
Claims Specialist
State Farm
Dunwoody, GA
2024 - Current
- Reviewed and processed insurance claims, ensuring compliance with policy guidelines and regulations.
- Evaluated claim documentation for accuracy, facilitating timely resolutions and enhancing customer satisfaction.
- Collaborated with teams to streamline claims processing workflows, improving efficiency in handling cases.
- Conducted thorough investigations into claims to identify fraud or discrepancies, safeguarding company assets.
- Led cross-functional meetings focused on optimizing claims processes, driving initiatives that improved service delivery outcomes.
- Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
- Enhanced customer satisfaction with timely communication, empathy, and clear explanations of claim outcomes.
- Developed strong working relationships with external partners such as adjusters, legal counsel, and medical professionals to facilitate efficient claim resolution processes.
- Provided exceptional customer service during stressful situations by offering empathy and support while resolving issues efficiently.
- Reduced claim processing errors by conducting thorough investigations and accurately interpreting policy details.
Patient Access Representative
Emory Healthcare
Atlanta, Ga
2017 - 2024
- Assisted patients with registration and appointment scheduling, ensuring a seamless access experience.
- Verified insurance information and resolved discrepancies to optimize patient billing processes.
- Provided support to front desk operations, enhancing overall patient flow and satisfaction.
- Educated patients on required documentation and procedures for efficient service delivery.
- Collaborated with clinical staff to coordinate patient care, ensuring timely follow-ups and communication.
- Maintained accurate electronic health records, contributing to data integrity and compliance.
- Trained new staff on patient access protocols, fostering a knowledgeable team environment.
- Implemented process improvements that enhanced operational efficiency within the department.
- Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.
- Provided excellent customer service through active listening skills, understanding patient needs, and offering tailored solutions where applicable.
- Developed proficiency in various healthcare software programs for accurate documentation of patient encounters and streamlined workflows within the department.
Education
Master of Science - Health Administration
Strayer University
Lithonia, GA10.2019
Kennesaw State University
Kennesaw, GA12.2015
Skills
- Claims
- Claims processing
- Claims investigation
- Verbal communication
- Microsoft office
- Settlement determinations
- Policy interpretation
- Compliance management
- Claims analysis
- Accident investigations
- Documentation review
- Complex claims consulting
- Negotiation leadership
- Liability denials
- Time management
- Decision-making
- Critical thinking
- Customer service
- Organizing and prioritizing work
- Attention to detail
Timeline
Claims Specialist
State Farm
2024 - Current
Patient Access Representative
Emory Healthcare
2017 - 2024
Master of Science - Health Administration
Strayer University
Kennesaw State University