Camauri A Williams
Woodlyn,PA
Summary
Adept at healthcare data management and showcasing exceptional analytical skills, I significantly enhanced risk adjustment processes at Humana Insurance Company. Leveraging medical coding expertise and time management abilities, I improved data accuracy and compliance, contributing to streamlined operations and better patient outcomes.
Overview
5
5
years of professional experience
Work History
Risk Adjustment Specialist
Humana Insurance Company
Louisville, KY
03.2023 - Current
- Maintained knowledge of current industry standards related to risk adjustment coding and reimbursement.
- Collaborated with other departments within the organization to ensure accurate data collection and reporting processes were followed.
- Monitored provider compliance with established policies, procedures, and regulations related to risk adjustment.
- Conducted in-depth analyses on potential risks, impacts of new legislation or potential economic factors related to financial activities.
- Analyzed claims data using statistical methods and software programs such as SAS or SQL.
- Researched new technologies that can be used to increase efficiency in the review process.
- Conducted analysis of risk adjustment data to identify opportunities for improvement.
- Evaluated patient charts for completeness, accuracy and compliance with applicable rules and regulations.
Patient Access Representative
Main Line Health System
Media, PA
06.2021 - 02.2023
- Processed patient admissions, registrations, transfers, and discharges according to established procedures.
- Assisted with scheduling outpatient appointments.
- Actively participated in team meetings and training sessions.
- Maintained confidentiality of all patient information in accordance with HIPAA regulations.
- Scanned documents into electronic medical records system.
- Performed pre-registration functions such as verifying demographic information, obtaining authorizations, and collecting deposits and co-payments.
- Created new patient accounts in the EPIC system as needed.
- Answered phones promptly in a professional manner.
- Updated reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies and list of accepted insurance plans.
- Managed patient check-in process, ensuring accurate data entry of personal and insurance information.
- Reviewed authorization requests for accuracy and completeness.
Obstetrics and Gynecology Scheduler
Crozer Chester Medical Center
Chester, PA
09.2019 - 06.2021
- Managed incoming calls to schedule appointments and answer questions
- Processed patient referrals and insurance verifications
- Maintained updated records of all scheduled appointments
- Communicated changes in policy or procedure updates to patients.
- Followed up with patients regarding upcoming appointments.
- Advised patients on the best options for their particular situation with nurse assistance
- Reviewed documentation for accuracy prior to submitting claims
- Monitored patient wait times to ensure timely service delivery
- Managed appointment setting, cancellations, and rescheduling for clients, enhancing patients' satisfaction.
- Stocked inventory and ordered office supplies
Education
Bachelor’s Degree - Human Services
Chestnut Hill College
Philadelphia, PA01.2025
Skills
- Healthcare data management
- HCC coding experience
- Medical coding expertise
- CMS guidelines
- Medical record review
- Risk adjustment methodologies
- Analytical skills
- Time management abilities
Timeline
Risk Adjustment Specialist
Humana Insurance Company
03.2023 - Current
Patient Access Representative
Main Line Health System
06.2021 - 02.2023
Obstetrics and Gynecology Scheduler
Crozer Chester Medical Center
09.2019 - 06.2021
Bachelor’s Degree - Human Services
Chestnut Hill College