Angela Budd
Cody,WY
Summary
A driven professional with extensive experience in medical claims and insurance policy processing, notably with Aflac; Deanna Christensen in Rock Springs, Wyoming. Excelled in supplemental, and health claims, leveraging expertise in HIPAA and medical billing to enhance processing efficiency. Demonstrated exceptional customer service and problem-solving skills, significantly improving claims accuracy and compliance.
Overview
1
1
Certification
Work History
Administrative Assistant
State Farm
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Maintained inventory of office supplies and placed orders.
- Surpassed team goals by partnering with colleagues to implement best practices and protocols.
- Opened and properly distributed incoming mail to promote quicker response to client inquiries.
- Interacted with vendors, contractors and professional services personnel to receive orders, direct activities, and communicate instructions.
- Established administrative work procedures to track staff's daily tasks.
- Managed filing system, entered data and completed other clerical tasks.
Medical Claims Specialist
Fremont Therapy Group
- Submitted electronic/paper claims documentation for timely filing.
- Paid or denied medical claims based upon established claims processing criteria.
- Reviewed provider coding information to report services and verify correctness.
- Responded to correspondence from insurance companies.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Managed large volume of medical claims on daily basis.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Processed insurance payments and maintained accurate documentation of payments.
- Researched and resolved complex medical claims issues to support timely processing.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Identified and resolved discrepancies between patient information and claims data.
- Generated reports on medical claims processing activities and results.
Insurance Claims and Policy Processing Clerk
Aflac
- Followed up with customers on unresolved issues.
- Collaborated with claims department and industry anti-fraud organizations to resolve claims.
- Managed workload and priorities to meet claims processing meet deadlines.
- Responded to customer inquiries, providing detailed explanations of insurance policies and claims processes.
- Assisted in onboarding of new claims processors to familiarize with company procedures, policies and processes.
- Identified and reported potential fraud or abuse related to claims to protect system's integrity.
- Tracked and reported on claims processing metrics to aid senior management in making informed decisions.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Complied with regulations and guidelines related to claims processing to maintain quality and adherence to standards.
- Developed and implemented quality assurance processes to check accuracy of claims processing.
- Utilized excellent analytical and problem-solving skills to quickly and accurately assess insurance claims.
- Verified client information by analyzing existing evidence on file.
Education
High School Diploma -
R5 High School
Grand Junction, COSkills
- Medicaid
- Medicare
- Health Insurance
- Claims processing
- Payment posting
- HIPAA
- Medical coding
- Medical billing
- Electronic claims processing
- Insurance claims processing
- Customer service
- EMT Basic Certification
Certification
- EMT Basic Certification, Northwest Community College, April 2024 (Wyoming State Certification)
- Previously licensed in Health Insurance, Supplemental Insurance, Life Insurance, Property/Casualty Insurance
- Member of the Park County Search and Rescue (Level 2 rope rescue training, emergency medical, and backcountry team)
Timeline
Administrative Assistant
State Farm
Medical Claims Specialist
Fremont Therapy Group
Insurance Claims and Policy Processing Clerk
Aflac
High School Diploma -
R5 High School
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