Arnitra Gray

• Conducted thorough review of patient benefits and insurance claims, ensuring accuracy in processing and documentation
• Collaborated with healthcare providers and patients to resolve discrepancies, enhancing the accuracy of patient records and billing
• Gained experience with healthcare compliance and payer-specific regulations, which directly applies to coding and billing roles
• Remote

• Adjudicated pharmacy claims, ensuring compliance with Medicare Part D and reviewing claim data for accuracy
• Communicated with healthcare providers to clarify and resolve claim issues, a skill that can be transferred to medical coding queries
• Worked with medical records and documentation, ensuring accurate coding and supporting efficient claims processing
• Remote

• Resolve escalated member grievances and complaints related to Medicare Part D benefits and claims.

• Analyze and interpret prescription benefit plans and CMS guidance to support resolution of complex inquiries.

• Collaborate with PBMs to identify claim discrepancies and ensure timely issue resolution.

• Educate providers on prior authorization requirements and plan limitations.

• Managed patient accounts, including verifying insurance coverage and processing claims with attention to accuracy and documentation
• Assisted patients with resolving billing issues and ensuring insurance claims were submitted correctly