Aly Hurley

Medical Adjudicator

Department Of Labor And Industries

04.2013 - 04.2022

Ensured accurate determinations with meticulous research and thorough investigation of disputes.
Continuously updated personal knowledge on relevant laws, regulations, and policies affecting the adjudication process within the jurisdiction served.
Evaluated claims by analyzing case files, conducting interviews, and reviewing relevant documentation.
Improved claim processing times by implementing efficient workflows and prioritizing urgent cases.
Reduced case backlogs by effectively managing workload and meeting strict deadlines for resolution.
Promoted fairness in adjudications through impartial assessment of facts and unbiased application of legal principles.
Mentored junior adjudicators on best practices, contributing to enhanced team performance overall.
Confirmed monthly billing actualizations and handled miscellaneous billing inquiries.
Enhanced billing accuracy by diligently reviewing invoices and resolving discrepancies.
Enhanced departmental understanding of regulatory compliance issues related to billing practices.
Streamlined the suspended billing process for increased efficiency and reduced errors.
Increased revenue by identifying and rectifying discrepancies in billing and pricing.
Enhanced billing efficiency by streamlining invoicing processes and implementing automated systems.
Liaised with patients and addressed inquiries, appointment requests and billing questions.
Improved billing accuracy by meticulously reviewing and verifying patient insurance information.
Coordinated with internal departments on billing issues, ensuring timely resolution of discrepancies.
Generated, distributed and filed copies of all billing paperwork.
Answered telephone calls and emails to resolve clients' billing issues and questions.
Ensured accuracy of billing information through regular audits and reconciliation efforts.
Monitored delivery and billing of customer products.
Assisted in billing processes, contributing to increased revenue collection and accuracy.
Enhanced patient satisfaction by promptly addressing concerns and resolving billing issues.
Collaborated with healthcare providers to ensure accurate billing and reimbursement procedures.
Negotiated payments, schedules and billing with actors and agents.
Prepared billing statements for patients and verified correct diagnostic coding.
Streamlined accounts receivable processes by implementing efficient invoicing and billing systems.
Reduced discrepancies in billing data by conducting regular audits and reconciliations.
Improved client satisfaction by addressing billing inquiries and resolving discrepancies promptly.
Coded correct procedures for physician and billing purposes.
Handled financial transactions accurately, ensuring proper billing and payment processing.
Completed all necessary paperwork accurately, ensuring proper documentation for billing purposes.
Streamlined billing procedures for increased revenue collection and reduced errors.
Collaborated with cross-functional teams, optimizing the overall medical billing process.
Liaised between patients, insurance companies, and billing office.
Monitored trends in billing disputes, proactively addressing potential concerns before escalation.
Simplified complex billing processes, resulting in increased efficiency and reduced errors.
Assessed billing automation, accounting, and real-time reporting and analytics capabilities.
Boosted clinic revenue with accurate billing and invoicing procedures.
Boosted customer satisfaction by promptly addressing inquiries and resolving billing issues.
Improved invoice accuracy by diligently reviewing billing documents and identifying discrepancies.
Monitored accounts receivable and billing departments.
Played key role in audit committee, providing insights and recommendations to guide organizational strategy.
Supported human resources department in addressing employment law issues, maintaining a fair working environment for all employees.
Coordinated with human resources personnel to manage workers'' compensation claims efficiently and fairly for injured employees.
Managed financial, operational and human resources to optimize business performance.
Collaborated with human resources teams to accommodate employees with special needs or disabilities, fostering an inclusive work environment.
Collaborated closely with cross-functional teams such as Marketing and Human Resources departments during large-scale recruitment initiatives.
Supported human resources department in areas such as people metrics, reporting, finance and analytics.
Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
Maintained confidentiality of sensitive information by adhering to strict privacy policies and implementing secure filing systems.
Delivered excellent customer service through prompt responses to client inquiries, addressing concerns effectively, and building strong relationships.
Ensured accurate record-keeping with diligent data entry and database management for vital company information.
Promoted a positive work environment through effective communication skills and fostering professional relationships among colleagues.
Improved document organization with thorough file maintenance, archiving outdated records as necessary for efficient retrieval when needed.
Assisted with human resources tasks such as updating employee files or submitting time-off requests per company policy guidelines.
Assisted in onboarding new employees, providing training materials, and coordinating orientation schedules to ensure a smooth integration into the team.
Optimized calendar management for executives by scheduling appointments strategically while considering priorities and minimizing conflicts.
Organized office events such as holiday parties or team-building activities, promoting a positive company culture and boosting employee morale.
Collaborated on special projects as assigned by leadership, contributing research findings or coordinating event logistics as needed for success.
Streamlined invoice processing procedures to ensure timely payment of vendors while minimizing errors in financial records.
Facilitated collaboration within team by organizing regular meetings and tracking project progress.
Boosted team productivity by managing communication channels and ensuring timely responses to inquiries.
Streamlined office operations, implementing digital file management systems to reduce paper use and increase efficiency.
Contributed to policy updates, researching regulations to ensure company compliance.
Facilitated cross-departmental communication, organizing meetings to discuss project progress and align objectives.
Facilitated training sessions for new software tools, increasing team productivity and reducing learning curves.
Enhanced office environment, organizing spaces for better workflow and employee comfort.
Enhanced communication within office, establishing weekly newsletter summarizing key updates and achievements.
Maintained confidentiality of sensitive information, adhering strictly to data protection regulations.
Addressed IT issues by coordinating with tech support, minimizing downtime and maintaining operational efficiency.
Improved staff morale by organizing recognition programs, acknowledging outstanding contributions and fostering positive work culture.
Managed filing system, entered data and completed other clerical tasks.
Managed phone and email correspondence and handled incoming and outgoing mail and faxes.
Assisted coworkers and staff members with special tasks on daily basis.
Demonstrated empathy by actively listening to claimants, fostering trust and understanding in sensitive medical adjudication cases.
Supported victims, family members and witnesses through law enforcement, healthcare and social services.
Collected statistical data and updated documentation to maintain client records.
Attended interagency meetings and networked to create community partnerships.
Constructed referral list of agencies and community resources for victims' to provide aftercare services.
Monitored clients' progress to adjust treatment plans accordingly.
Evaluated clients' social, emotional and psychological needs to create treatment plans.
Educated clients and families on mental health, wellness and recovery topics.

Summary

Overview

Work History

Claims Examiner

Claims Adjuster

Medical Adjudicator

Education

Associate Degree In Nursing - Mental Health

High School Diploma -

Skills

Certification

Timeline

Claims Examiner

Claims Adjuster

Medical Adjudicator

Associate Degree In Nursing - Mental Health

High School Diploma -

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