Ashley Tauaefa
Anchorage,United States
Overview
4
4
years of professional experience
Work History
Medical Claims Specialist
ALASKA NATIVE MEDICAL - PURCHASED REFERRED CARE
02.2020 - Current
- Managed large volume of medical claims on daily basis.
- Provides claim status to billing providers .
- Verified patient insurance coverage and benefits for medical claims.
- Trains and mentors medical claims team. Created job aids to help ease the training process as well as communicating any new changes to claims processing.
- Communicates with IHS beneficiaries to help understand PRC policy's and guidelines.
- Monitors the PRC spending plan, fund status reports and submits written requests for supplemental PRC funds, including budget information for congressional hearings.
- Reviews, analyzes, and summarizes pertinent financial, statistical, and program data.
- Provides consultation on proper billing procedures, interpretation of guidelines, verification of claims, appropriateness of services, and irregularities in billing information received.
Timeline
Medical Claims Specialist
ALASKA NATIVE MEDICAL - PURCHASED REFERRED CARE
02.2020 - Current
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