Experienced medical professional with diverse expertise in hospital administration, including admitting, data management, billing, and medical records. Proficient in navigating various roles to enhance personal growth and contribute to team success.
Overview
31
31
years of professional experience
Work History
Insurance Claims Specialist
Renown Health
Reno, USA
08.2015 - 08.2024
Follow up with INS.
Evaluated and settled complex insurance claims in strict timeframes.
Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
Affirmed or denied coverage.
Followed up with INS representatives on unresolved issues.
Reported policy changes with any INS that renown is unaware of.
Communicated verification and authorization status updates.
Coordinated with supervisor and INS Reps to resolve payer issues.
Data Entry
John C. Fremont Hospital
Mariposa, USA
06.1993 - 05.2014
Scanned documents and saved in database to keep records of essential organizational information
Managed documents by organizing forms, making photocopies, filing records, preparing correspondence and creating reports
Corrected data entry errors to prevent later issues such as duplication or data degradation
Accurately handled data entry into company-based software
Evaluated source documents to locate information needed for each data entry field
Increased data-entry productivity by maintaining detailed logs of data projects, identifying issues and improving them
Education
Some College (No Degree) - Basic Field
Merced Junior College
Merced, CA
Skills
Claims Evaluations
Team Collaboration
Insurance knowledge
Claims Investigation
Claim Amount Calculations
Data Entry
Eligibility Determination
10-Key Touch
Payment and Investigation Escalations
Insurance Coverage Verification
Claims Processing
Teamwork and Collaboration
References
References available upon request.
Timeline
Insurance Claims Specialist
Renown Health
08.2015 - 08.2024
Data Entry
John C. Fremont Hospital
06.1993 - 05.2014
Some College (No Degree) - Basic Field
Merced Junior College
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