Bonnie Butler
Glendale,AZ
Summary
Medical Claims Analyst with extensive experience in compiling, reviewing, and adjudicating complex claims across Medicare, Medicaid, commercial, and behavioral health lines. Expertise in interpreting CPT, HCPCS, ICD-9, and ICD-10 coding while resolving appeals and payment issues with providers and insurers to ensure compliance with federal, state, and company guidelines. Committed to maintaining payment accuracy through meticulous validation of claim data and identification of missing documentation, consistently managing over 250 claims per week within established turnaround standards. Reliable medical logistics professional recognized for executing precise medical deliveries while safeguarding sensitive materials and adapting to dynamic schedules through effective route planning and teamwork.
Overview
15
15
years of professional experience
Work History
Independent Medical Courier
1099 Contractor
Phoenix, AZ
03.2024 - Current
- Coordinated timely delivery of medical supplies and specimens to healthcare facilities.
- Managed route planning to optimize delivery efficiency and minimize delays.
- Ensured compliance with safety protocols and handling procedures for sensitive materials.
- Collaborated with healthcare professionals to confirm delivery specifications and requirements.
- Monitored vehicle maintenance schedules to ensure operational readiness and reliability.
- Provided exceptional customer service by addressing inquiries and resolving issues promptly.
- Upheld compliance with HIPAA regulations while managing confidential patient information during deliveries.
- Ensured patient confidentiality by properly handling sensitive medical documents and specimens during transport.
- Maintained a clean, organized, and safe vehicle environment to ensure the proper handling of medical supplies and equipment.
- Communicated route progress to management, noting traffic, and construction issues to avoid delays for critical deliveries.
- Improved customer satisfaction by providing timely updates on shipment status and addressing concerns promptly.
- Properly documented all specimens received using [Software].
- Enhanced delivery efficiency by optimizing route planning and adhering to strict schedules.
- Minimized errors in specimen handling by adhering to established guidelines for labeling, packaging, and temperature control requirements.
- Obtained signatures for delivery documents and packages.
- Built professional relationships with customers and business partners to establish trust and credibility.
- Loaded and unloaded packages onto delivery vehicles for proper storage and handling.
- Communicated with dispatch and customers for accurate delivery information.
- Tracked delivery status and updated customers for expected delivery time.
- Maximized processes by managing delivery schedules and prioritizing based on urgency.
- Handled receipt, storage, identification and delivery of products for clients.
- Contributed to the overall success of the company by consistently prioritizing customer needs, maintaining a strong work ethic, and demonstrating a commitment to excellence in every aspect of the role.
- Supported team members during high-volume periods or absences by covering additional routes when necessary.
Medical Claims Analyst
Banner Health
Mesa, AZ
11.2021 - Current
- Managed a large caseload of complex medical claims while meeting turnaround times set by the company's standards.
- Collaborated with internal teams and external partners to resolve issues related to claim processing or appeals, ensuring timely resolution.
- Verified and analyzed data used in settling claims to validate claims and settlements according to company practices and procedures.
- Compiles data on claim forms to verify accuracy of information prior to submission for payment processing.
- Payed and processed claims within designated authority level.
- Processed and paid claims within designated authority level, maintaining compliance with company standards.
- Analyzed information gathered during investigations and reported findings and recommendations to support claim decisions.
- Confirm proper legal procedures by complying with federal, state and company regulations.
Medical Claims Analyst
The Jacobson Group
02.2020 - 08.2021
- Review and validate all claims (Commercial, Medicare and Medicaid) to ensure that there is no missing or incomplete information.
- Analyze claims from first submission to finalization.
- Maintained complete and accurate processing of claims, ensuring discretion and confidentiality.
- Processed and tracked claims with precision to ensure timely payments.
- Pay / Track Claims accurately.
- Responded to inquiries and resolved specific claim issues to enhance stakeholder satisfaction.
- Collaborate with other departments to obtain necessary information for resolution of claims.
- Attends training sessions, conferences and workshops to keep abreast of current practices and programs for the purpose of conveying and/or gathering information required to perform functions.
Payment Poster/Senior Claims Specialist
PRSA Behavioral Health Agency
Phoenix, AZ
10.2017 - 05.2018
- Researched, reconciled, and rebilled claims, separating them by funding categories on Credible.
- Corresponded with funding sources by email, phone, and fax regarding claim issues and made decisions on all agency claims.
- Oversaw monthly client eligibility issues for RHEA(s) and collaborated with funding sources to resolve billing issues.
- Assisted in creating and maintaining agency reports regarding any claim issues.
- Provided support to claims specialists by assisting with their tasks and responsibilities.
- Processed Behavioral and Medical claims for major and private insurance carriers across all lines of business.
- Assisted the Claims Manager with incoming data files for the agency’s contracts and special projects.
Subject Matter Expert/Medical Claims Analyst II
TriZetto, A Cognizant Company
Phoenix, AZ
01.2016 - 04.2017
- Maintained external customer relations by serving as key contact for clients on claims issues, researching accurate claim information, and updating claim files to reflect status and payments.
- Processing complex claims for multiple plans with automated and manual differences in benefits, as well as utilizing the system and written documentation to determine the appropriate payment for a specific benefit.
- Troubleshooting all claims with potential third-party liability, i.e. subrogation, COB, or MVA and stop loss claims and potential stop loss files.
- Approving, pending, or denying payment according to the accepted coverage guidelines.
- Maintaining external customer relations by interacting with clients regarding claims issues, providing service as key contact for clients and working as directed with the client vendors, researching and ensuring accurate and complete claim information, contacting insured or other involved parties for additional or missing information and updating claim file information regarding claims status, questions or claim payments.
- Trained new groups and staff while assisting the management team in problem resolution, planning and overseeing workflows.
- Executed quality control audits to assess staff performance and compliance.
- Conducted routine audits for operational staff across claims, data entry, enrollment, billing, customer service, and provider file maintenance to ensure compliance and identify areas for improvement.
- Developing, preparing and reporting results of service level and process audits and providing error statements for explanation of errors to audited staff and management.
- Providing information to the quality management leadership team regarding the need for group and/or individual training based on audits.
- Performing focus audits, creating ad hoc reports and summarizing results for management and/or the client.
- Performing system testing to ensure that business processes are functioning as designed and established.
- Participating on project teams as needed.
- Assist with Benefit Rule Configuration team on troubleshooting system issues daily.
Medicare Claims Analyst I
Health Choice Arizona
Phoenix, AZ
05.2015 - 01.2016
- Enter claims data accurately and timely, in alignment with departmental production and goals.
- Facilitated timely claim payments in accordance with contractual agreements.
- Correctly adjudicates claims for contracted/non-contracted providers.
- Review respective coding (i.e. CPT, HCPCS, ICD-9) to ensure that claims are billed in compliance with CMS and Correct Coding guidelines.
- Reviewed coding (CPT, HCPCS, ICD-9) to ensure claims compliance with CMS and Correct Coding guidelines.
- Identify and refer third party liability or coordination of benefits issues to the COB/TBL Coordinator.
- Communicated trends to Claims Department Supervisor to support development of provider training programs.
Medical Claims Processor II
Trizetto, A cognizant company
Linthicum Heights, MD
10.2011 - 04.2014
- Processed and analyzed 150+ claims per day, providing strategic recommendations while working with several vendors including Affinity, Blue Cross and Blue Shield, and Lovelace Health Plan.
- Resolved complex claim denials via phone, referring customer grievances to designated departments for further investigation and resolution.
- Ensured 100% compliance with all mandated government and state regulations, as well as approving, pending or denying payment according to accepted coverage guidelines.
- Researched claims status using appropriate service application, providing written responses to providers and addressing claims adjustment requests.
- Played a key role on numerous committees and special project teams, and assisted client trainer in issue resolution, planning, and overseeing workflow.
- Processed and analyzed 150+ claims daily, collaborating with vendors including Affinity, Blue Cross and Blue Shield, and Lovelace Health Plan to deliver strategic recommendations.
Education
High school diploma or GED -
Jamaica High School
New York, NYMaster of Arts - Health Care Management
University of Arizona
Tucson, AZ05-2025
Bachelor of Science - Health Care Management
Grand Canyon University
Phoenix, AZ02-2023
Skills
Claims processing
ICD-10
Medical terminology
Regulatory compliance
Claims auditing
Appeals resolution
Prior authorization
Medical records review
Data accuracy verification
System testing
Transporting medical specimens
Transport laboratory specimens
Delivery route optimization
Delivery tracking systems
Delivery tracking documentation
Package pickup and delivery
Package organization
Local routes
Inventory management
Safe driving practices
Safety procedures
Safety compliance checks
Confidentiality awareness
HIPAA compliance
Customer satisfaction
Problem-solving
Problem-solving
Attention to detail
Multitasking
Teamwork and collaboration
Organizational skills
Decision-making
Analytical thinking
Delivery status tracking
Secure loads
Transport laboratory specimens
Timeline
Independent Medical Courier
1099 Contractor
03.2024 - Current
Medical Claims Analyst
Banner Health
11.2021 - Current
Medical Claims Analyst
The Jacobson Group
02.2020 - 08.2021
Payment Poster/Senior Claims Specialist
PRSA Behavioral Health Agency
10.2017 - 05.2018
Subject Matter Expert/Medical Claims Analyst II
TriZetto, A Cognizant Company
01.2016 - 04.2017
Medicare Claims Analyst I
Health Choice Arizona
05.2015 - 01.2016
Medical Claims Processor II
Trizetto, A cognizant company
10.2011 - 04.2014
High school diploma or GED -
Jamaica High School
Master of Arts - Health Care Management
University of Arizona
Bachelor of Science - Health Care Management
Grand Canyon University