Beyondria Green
Columbia,SC
Summary
Professional in insurance claims and policy processing with a proven track record of high productivity and precision in task completion. Expertise in analyzing claim details, navigating policy databases, and managing customer communications. Strong problem-solving abilities and adaptability enhance teamwork and facilitate positive outcomes in complex situations.
Overview
8
8
years of professional experience
Work History
Claims Specialist (Remote)
Recruiting Solutions Inc
10.2023 - 05.2025
- Handled all assigned claims promptly and effectively
- Escalated all claims to necessary departments and reviewed all claims documents for accuracy
- Reviewed medical records and documents to determine coverage eligibility of claims for insurance benefits.
- Interacted with providers regarding claim status or other related issues as required.
- Verified insurance coverage and eligibility of patients for services rendered.
- Submitted appeals to payers when necessary to resolve denied or underpaid claims.
Claims Processor (Remote)
Totalmed Staffing
01.2022 - 10.2023
- Verified insurance coverage and eligibility of patients for services rendered.
- Submitted appeals to payers when necessary to resolve denied or underpaid claims.
- Reviewed and processed medical claims for accuracy and completeness according to established guidelines.
- Assessed coding accuracy, using ICD-10 codes, CPT codes, HCPCS codes, and modifiers.
- Monitored accounts receivable aging reports to ensure timely payments from payers.
Medical Claims Follow-Up Rep (Remote)
Employer
07.2017 - 01.2022
- Interacted with providers regarding claim status or other related issues as required.
- Monitored accounts receivable aging reports to ensure timely payments from payers.
- Submitted appeals to payers when necessary to resolve denied or underpaid claims.
- Assessed coding accuracy, using ICD-10 codes, CPT codes, HCPCS codes, and modifiers.
- Accurately processed large volume of medical claims every shift.
Education
High School Diploma -
Lower Richland High
Hopkins, SC05-2009
Skills
- Documentation Review
- Data Entry
- Medical Billing
- Eligibility Determination
- Customer Service
- Microsoft Office
- Data Analysis
- Medical Coding
- Medical Terminology
- Claims Appeals
- Proficiency in Epic, Meditech, Cerner, etc
Timeline
Claims Specialist (Remote)
Recruiting Solutions Inc
10.2023 - 05.2025
Claims Processor (Remote)
Totalmed Staffing
01.2022 - 10.2023
Medical Claims Follow-Up Rep (Remote)
Employer
07.2017 - 01.2022
High School Diploma -
Lower Richland High