Antionette White
McDonough,GA
Summary
Dynamic Insurance Claims Specialist with a proven track record at Emory University Hospital Midtown, excelling in claims analysis and customer service. Enhanced processing efficiency through workflow improvements and mentored teams on best practices. Skilled in claims investigation and active listening, driving higher claim approval rates and ensuring compliance with hospital policies.
Experienced with managing intricate insurance claims and resolving disputes efficiently. Utilizes deep knowledge of policy and regulatory guidelines to ensure compliance and fair settlements. Track record of maintaining client trust and achieving operational excellence.
Insurance professional with comprehensive experience in claims management, adept at assessing, processing, and resolving claims efficiently. Proven skills in investigation, analysis, and negotiation, ensuring fair outcomes and policy compliance. Strong focus on team collaboration and adaptability, delivering results through effective communication and problem-solving. Reliable and flexible, meeting changing needs and maintaining high standards in all tasks.
Overview
24
24
years of professional experience
Work History
Insurance Claims Specialist
Emory University Hospital Midtown
Atlanta, GA
02.2017 - Current
- Processed and analyzed insurance claims to ensure compliance with hospital policies.
- Coordinated communication between patients, providers, and insurance companies to resolve claim issues.
- Reviewed claims for accuracy and completeness, identifying discrepancies for resolution.
- Implemented workflow enhancements that improved claims processing efficiency by streamlining documentation procedures.
- Mentored junior staff on best practices in claims management and customer service protocols.
- Conducted training sessions on new software tools to optimize claims processing capabilities within the team.
- Led initiatives to improve claim approval rates through detailed analysis of common denial reasons.
- Developed comprehensive reports on claims trends to inform strategic decision-making by management.
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Enhanced customer satisfaction by efficiently managing insurance claims processes and providing timely resolutions.
- Evaluated and settled complex insurance claims in strict timeframes.
- Followed up with customers on unresolved issues.
Phlebotomist
Quest Diagnostics
Atlanta, GA
02.2002 - 02.2016
- Conducted venipunctures and capillary draws with precision and adherence to safety protocols.
- Maintained accurate patient records and ensured compliance with regulatory standards.
- Collaborated with healthcare teams to facilitate effective patient care and blood collection processes.
- Trained and mentored new phlebotomists on best practices and procedures.
- Streamlined specimen processing workflows, enhancing overall operational efficiency.
- Implemented quality control measures to ensure sample integrity and reliability of results.
- Utilized laboratory information systems for efficient data entry and tracking of specimens.
- Enhanced patient experience through compassionate care and communication during blood draw procedures.
- Labeled transfer tubes and followed exact directions for handling and storing specimens for transport.
- Maintained a high level of accuracy in labeling and tracking specimens, ensuring proper testing and timely results.
- Centrifuged blood samples as outlined in clinical protocols.
- Completed proper sanitation and cleaning of equipment and work areas between patients.
- Excelled in high-pressure situations, maintaining composure and professionalism during peak hours and emergency scenarios.
- Tracked collected specimens by initialing, dating, and noting times of collection.
- Stocked phlebotomy cart or carrier with appropriate supplies.
Education
No Degree - Health Care Administration
Dekalb Technical Institute
Covington Ga04-2022
Skills
- Claims investigation
- Claims analysis
- Policy interpretation
- Teamwork and collaboration
- Attention to detail
- Customer service
- Active listening
- Claims processing
- Data entry
- Insurance coverage verification
- Organizing and prioritizing work
- Claim amount calculations
- Claims adjustment
- Documentation skills
- Decision-making
- 10-key touch
- Medical terminology
Timeline
Insurance Claims Specialist
Emory University Hospital Midtown
02.2017 - Current
Phlebotomist
Quest Diagnostics
02.2002 - 02.2016
No Degree - Health Care Administration
Dekalb Technical Institute