Allison Mitchell

2013-2024:

Process high $ transplant claims,includes receiving claims bundle from medical facilities,review claims bundle and process for payment

• Streamlined communication between clients and team members for improved project efficiency.
• Managed a diverse portfolio of clients, ensuring timely and accurate reporting on account activities.

• Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
• Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
• Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
• Responded to customer requests for products, services, and company information.

• Processed high volumes of medical claims accurately and efficiently under tight deadlines, ensuring prompt payment for services rendered.
• Researched and resolved complex medical claims issues to support timely processing.
• Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
• Verified patient insurance coverage and benefits for medical claims.
• Managed large volume of medical claims on daily basis.
• Monitored and updated claims status in claims processing system.
• Paid or denied medical claims based upon established claims processing criteria.
• Evaluated medical claims for accuracy and completeness and researched missing data.
• Processed insurance payments and maintained accurate documentation of payments.
• Contributed to positive team morale through active participation in department meetings, offering constructive feedback, and supporting colleagues when needed.
• Resolved discrepancies between billed amounts and allowed charges promptly by working closely with both providers and payers, minimizing delays in payment processing times.
• Mastered various proprietary claim processing systems quickly allowing seamless adaptation to new technology initiatives within the organization.