Summary
Overview
Work History
Education
Skills
Timeline
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Carol Kristensen

Layton,Utah

Summary

Experienced medical claims processor and medical office manager with over 20 years experience in fast-paced, high volume environments. Skilled in quickly resolving issues and liaising between insurance providers, companies and policyholders. Excellent interpersonal and customer service skills.

Overview

33
33
years of professional experience

Work History

Assistant Manager & Massage Therapist

iMassage
01.2018 - Current
  • Improve customer satisfaction by addressing and resolving complaints promptly.
  • Develop strong working relationships with staff, fostering a positive work environment.
  • Collaborated with the management team to develop strategic plans for business growth and improvement.
  • Reduced errors in payroll calculations with meticulous attention to detail and thorough data verification.
  • Massage Therapy for clients using various modalities to reduce pain and stress

Senior Subrogation Coordinator

SelectHealth
01.2008 - 01.2017
  • Expedited claim resolution times with proactive communication between patients, providers, and insurance companies.
  • Increased client satisfaction by efficiently managing 1300+ case files and promptly addressing inquiries.
  • Negotiated settlement amounts with attorneys and insurance carriers.
  • Developed strong relationships with TPL carriers and attorneys to facilitate efficient information exchange and cooperation.
  • Collaborated with physicians to obtain necessary documentation, improving claim approval rates.
  • Achieved timely reimbursements for clients through keen understanding of insurance protocols.

SIU Analyst & Supervisor

SelectHealth
10.2006 - 01.2008
  • Conducted thorough investigations on suspicious cases, ensuring timely resolution and minimizing financial impact.
  • Developed customized reports for senior management, highlighting key trends and insights on fraud-related issues.
  • Enhanced business efficiency by identifying fraud trends and patterns in complex datasets.
  • Managed scheduling and workload distribution, maximizing productivity without overwhelming team members or compromising quality of work.
  • Evaluated staff performance regularly, offering constructive feedback designed to promote growth within their roles.

Administrative Assistant

SelectHealth
01.2003 - 01.2006
  • Enhanced office efficiency by streamlining administrative processes and implementing organizational systems.
  • Supported management staff through scheduling meetings, coordinating team work flow, and preparing crucial documents from SIU departments

Team Leader

Benefit Planners
01.1999 - 01.2003

Claims Trainer and Auditor

IHC Health Plans
01.1991 - 01.1993
  • Reviewed medical claims for payment accuracy / Trained new employees on claims payment system /
  • Audited trainees daily work / Approved trainees for passing work and continuing employment.

Education

Renaissance College of Massage Therapy
Bountiful, UT
2018

Business

Weber State University
Ogden, UT
2012

Salt Lake Community College
Salt Lake City, UT
1987

Skills

  • Insurance Claims Processing
  • Excellent Customer Service
  • ICD-10-CM Understanding
  • Analytical Thinking
  • Excellent interpersonal skills
  • Self-starter and self-motivated
  • Workload Management
  • Negotiation Skills
  • Advanced Medical Terminology
  • Conflict Resolution

Timeline

Assistant Manager & Massage Therapist

iMassage
01.2018 - Current

Senior Subrogation Coordinator

SelectHealth
01.2008 - 01.2017

SIU Analyst & Supervisor

SelectHealth
10.2006 - 01.2008

Administrative Assistant

SelectHealth
01.2003 - 01.2006

Team Leader

Benefit Planners
01.1999 - 01.2003

Claims Trainer and Auditor

IHC Health Plans
01.1991 - 01.1993

Renaissance College of Massage Therapy

Business

Weber State University

Salt Lake Community College

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Carol Kristensen