Aminah Edwards
Addison,TX
Summary
Claims Specialist with expertise in claims processing and appeal filing. Diplomatic and personable professional accustomed to handling sensitive, confidential information and investigating claims. Committed to maintaining customer satisfaction and contributing to company success.
Overview
4
4
years of professional experience
Work History
Claims Specialist
Specialty Care Clinics
04.2023 - Current
- Investigates denials to locate compensable diagnostic codes to ensure payment
- Handled upwards of 15-30 claims per day
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Understood requirements for disputes, gathered evidence to support claims and prepared customer cases to handle appeals.
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
- Conducted full claim investigations and reported updates
Escalations Supervisor
Genpact, WFH
11.2020 - 02.2023
- Supervise and assist Front Office agents with processes and procedures in order to perform daily functions of their positions
- Resolved customer complaints quickly and professionally to restore customer confidence and prevent loss of business.
- Offered suggestions and alternatives to provide customers with solutions, boosting customer satisfaction.
- Built and maintained relationships with customers to increase sales, customer loyalty and positive word-of-mouth.
- Completed between 30-50 escalated customer calls daily
- Followed up on customer interactions to maintain customer communication and successfully close resolved issues.
Claims Recovery Specialist
HMS/ Acara
06.2019 - 11.2020
- Submitting Appeals & Supporting documentation for denied claims
- Worked productively in fast-moving work environment to process large volumes of claims.
- Researched and analyzed complex claims to determine next steps and possible outcomes.
- Handled between 10-15 claims daily
- Monitored and updated claims status in claims processing system.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
Education
Associate of Science - Accounting And Business Management
Collin College
Online Campus05.2024
Skills
- Excellent Computer Skills
- Microsoft Office Proficient
- Strong Problem Solving & Conflict Resolution Skills
- Excellent Verbal and Written Communication Skills
- Organized /Reliable
- Fast Learner
- Strong interpersonal &
- Attention to detail skills
Timeline
Claims Specialist
Specialty Care Clinics
04.2023 - Current
Escalations Supervisor
Genpact, WFH
11.2020 - 02.2023
Claims Recovery Specialist
HMS/ Acara
06.2019 - 11.2020
Associate of Science - Accounting And Business Management
Collin College
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