ARIYAN HOLTON
Shaker Heights,OH
Summary
Organized professional with experience in the insurance industry. Skilled in providing excellent customer service and solving complex claims issues. Proven ability to develop and maintain strong working relationships with clients. Adept in data analysis and dispute resolution techniques.
Overview
27
27
year of professional experience
Work History
Revenue Cycle Specialist II
University Hospitals, Ahuja Medical Center
02.2024 - Current
- Processed insurance claims, ensuring accuracy and compliance with regulations.
- Reviewed patient accounts to identify discrepancies and resolved billing issues promptly.
- Collaborated with healthcare providers to obtain necessary documentation for claim submissions.
- Assisted in training new staff on policies, procedures, and best practices in revenue cycle management.
- Maintained effective communication with patients regarding billing inquiries and payment plans.
- Utilized electronic health record systems to streamline data entry and enhance record accuracy.
- Trained new team members on revenue cycle best practices, contributing to a more knowledgeable workforce.
Insurance Claims Representative
New York Life Insurance Company
- Interviewed or corresponded with claimants and witnesses to determine claim settlement, denial, or review.
- Examined policy coverage records and forms to determine insurance coverage.
- Recognized potential fraudulent claims to move case to special investigative unit.
- Utilized knowledge of insurance policies and procedures to determine coverage eligibility.
- Successfully resolved escalated claims to ensure customer satisfaction.
- Interviewed clients and took calls to provide customer service and obtain information on claims.
Product Interviews Representative
New York Life Insurance Company
- Collaborated with internal departments to develop and maintain underwriting standards and procedures.
- Documented medical data in patient charts facilitating accurate records.
- Remained open to feedback from supervisor and peers to build and improve skills set.
- Assisted with mentoring new employees during and after training.
- Maintained knowledge of company products to provide helpful suggestions and recommendations to customers.
Recycle Management Billing Specialist
Cleveland Clinic
- Reviewed and posted daily payments.
- Maintained accurate and complete billing system and process.
- Negotiated payment terms and contracts with clients.
- Assisted billing team with other value-added projects.
- Responded to telephone inquiries and complaints following standard operating procedures.
- Delivered personalized customer service relating to questions and promptly resolved basic problems on customer accounts.
Prior Authorization Representative
Spherion Staffing/Memeber Health Services
- Communicated with others to obtain and verify eligibility information.
- Navigated through computer screens to complete and review documents and other forms.
- Interviewed applicants to obtain and verify information to determine eligibility for supportive services.
- Documented communications and contacts with clients to maintain records.
Education
Bryant and Stratton
Berea, OHCriminal Justice
Shaker Heights Highschool
Shaker Heights, OHHigh School Diploma - undefined
Skills
- Claims Evaluations
- Policy Knowledge
- Information Updates
- Reading Comprehension
- Microsoft Office
- Claims investigation
- Time management
- Insurance claims review
Awards
High School Diploma
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Revenue Cycle Specialist II
University Hospitals, Ahuja Medical Center
02.2024 - Current
Insurance Claims Representative
New York Life Insurance Company
Product Interviews Representative
New York Life Insurance Company
Recycle Management Billing Specialist
Cleveland Clinic
Prior Authorization Representative
Spherion Staffing/Memeber Health Services
Criminal Justice
Shaker Heights Highschool
High School Diploma - undefined
Bryant and Stratton
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