ANGELICA MOSMAN
Devoted Guardians
Tucson,AZ
2
Languages
11
years of professional experience
Offering strong commitment to healthcare services and patient care, with eagerness to learn and grow in this environment.
Work History
Caregiver
7 Months- Developed individualized care plans in collaboration with healthcare professionals.
- Provided compassionate care and support to clients in daily living activities.
- Assisted clients with mobility, ensuring safety and comfort during transitions.
- Administered medications according to prescribed schedules, maintaining accurate records.
- Facilitated communication between clients, families, and medical personnel to enhance care quality.
- Implemented health monitoring routines that improved client well-being and satisfaction.
Claim Liasion II
5 Years 5 Months- Facilitated communication between departments to streamline patient care processes.
- Address inquiries related to claims status, denials, and payments, ensuring timely and accurate resolution.
- Conduct comprehensive research to identify root causes of claims issues and collaborate with various departments to resolve them effectively.
- Acting as a bridge to facilitate communication between the plan, claims, and providers.
- Audit check run and send claims to the claims department for corrections.
- Document, track and resolve all plan providers’ claims projects.
- Research the claims on various reports to determine if appropriate to move forward with recovery due to non-covered items being allowed.
Claims Analyst
4 Years 6 Months- Analyzed claims data to ensure compliance with regulatory requirements and company policies.
- Reviewed and interpreted medical documentation to determine claim validity and payment accuracy.
- Utilized claims processing systems for efficient tracking and management of claims workflow.
- Identified trends in claim denials and developed strategies for process improvement.
- Trained junior analysts on best practices for claims processing and compliance standards.
- Ensure compliance with company policies regarding payments and denials.
- Review claims to assess reimbursement eligibility.
- Reduced fraudulent claims by conducting thorough investigations and collaborating with the fraud detection team.
Education
High School Diploma
Certificate - Coding And Billing
- Ranked in Top 5% of class
- Maintained 3.96 GPA
Languages
English
Native or Bilingual
Spanish
Full Professional
Timeline
Caregiver
Devoted Guardians
01.2026 - 08.2026Read More
Claim Liasion II
Centene, Superior Health Services
07.2020 - 12.2025Read More
Claims Analyst
Centene
01.2016 - 07.2020Read More
Sunnyside High School
High School Diploma
Read More
Brookline College
Certificate from Coding And Billing
Read More