Summary
Overview
Work History
Education
Skills
Timeline
BusinessDevelopmentManager

Aulondria Ransburgh

Byram,Mississippi

Summary

Tactful Claims Specialist with expertise in settlement preparation, claims processing and appeal filing. Diplomatic and personable professional accustomed to handling sensitive, confidential information and investigating complex liability claims. Committed to maintaining customer satisfaction and contributing to company success

Overview

7
7
years of professional experience

Work History

92A Automated Logistical Specialist

US Army
10.2018 - Current
  • Supervised team of helpers, laborers and material movers to efficiently complete tasks.
  • Maintained accurate records of team attendance and documented disciplinary actions.
  • Developed and implemented strategies to improve team productivity and efficiency.
  • Handled day-to-day shipping and receiving overseeing more than 50 packages per day.

Medical Transportation Appointment Scheduler

Modivcare
07.2021 - 08.2023
  • Acted as first point of contact and set appointments for prospective clients.
  • Handled complaints and questions, and re-directed calls to other team members.
  • Answered phone calls and answered questions from potential customers.
  • Worked with supervisors and team members to understand supply needs and bring levels within desired tolerances.

Claims Specialist

Prime Therapeutics LLC
10.2023 - 05.2024
  • Followed up with customers on unresolved issues.
  • Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
  • Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
  • Evaluated and settled complex insurance claims in strict timeframes.
  • Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.

Medical Claims Specialist

Magnolia Health Plan
06.2024 - 07.2025
  • Submitted electronic/paper claims documentation for timely filing.
  • Used administrative guidelines as resource or to answer questions when processing medical claims.
  • Reviewed provider coding information to report services and verify correctness.
  • Paid or denied medical claims based upon established claims processing criteria.

Education

Bachelor of Science - Psychology

Colorado Technical University
Colorado Springs, CO

Skills

  • Claims
  • Claims Processing
  • Claims Investigation
  • Verbal Communication
  • ICD-10 Proficiency
  • HIPPA Compliance & Confidentiality
  • Customer Service
  • Time Management
  • Healthcare Compliance
  • Patient Rapport
  • Data Entry & Claims System Navigation
  • Explanation of Benefits Interpretation

Timeline

Medical Claims Specialist

Magnolia Health Plan
06.2024 - 07.2025

Claims Specialist

Prime Therapeutics LLC
10.2023 - 05.2024

Medical Transportation Appointment Scheduler

Modivcare
07.2021 - 08.2023

92A Automated Logistical Specialist

US Army
10.2018 - Current

Bachelor of Science - Psychology

Colorado Technical University

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Aulondria Ransburgh