Christopher Daniels
Summary
Dedicated and focused individual who exceeds at prioritizing, completing, composing multiple tasks projects simultaneously by capturing, translating processes, and following through to achieve and value my mission and project goals with integrity, commitment, and innovation in an institution.
Overview
1
1
Certification
7
7
years of professional experience
Work History
Claims Representative Associate (Remote)
Optum
Eden Prairie, MN
11.2023 - Current
- Conducted thorough investigations of claims by reviewing documents, interviewing involved parties, and consulting with policyholders for additional information.
- Reviewed and processed incoming claims for accuracy in data entry and compliance with regulations.
- Applied knowledge of Medicare and Medicaid guidelines in reviewing claims to ensure the appropriate use of modifiers, NDC, and CPT/ICD-10 codes.
- Processed and utilized multiple outside systems to pull required data elements for hospital claims using NDC, UNET, Home Infusion, and TRACR.
- Updated policies and claims to reflect changes in beneficiary, coverage amounts, or insurance types.
- Precisely calculated refunds, premiums, coordinated adjustments, and planned investigations of claims to confirm compensability and coverage.
- Transcribed data to worksheets and entered into computer for document preparation and account adjustments.
- Researched complex cases involving multiple providers or policies.
Direct Processor (Remote)
Caliber Home Loans
Coppell, TX
09.2020 - 10.2023
- Acted as a subject matter expert (SME) regarding Caliber's processing policies, procedures, and technology.
- Conducted daily reviews and follow-ups with customers and vendors on outstanding items, gathering necessary documentation to facilitate timely processing.
- Collaborated with underwriters and loan officers to resolve application issues.
- Verified borrower information, including income, assets, liabilities, and employment history to ensure accuracy and compliance in loan applications.
- Reviewed title reports, payoffs, appraisals, income documents, hazard insurance, and supporting conditions to ensure compliance with FHA, VA, FNMA, and FHLMC guidelines before underwriter submission.
- Provided customers and the closing agent with necessary requirements, and coordinated scheduling for the completion of the loan closing.
- Received and finalized closing disclosures with lender(s) to determine cash to/from closing.
- Worked closely with officers and underwriters to ensure each file gets to closing smoothly.
- Worked with various title companies to get the necessary information and documents in order to push a file to the underwriter.
Billing Coordinator/Assoc Imaging Clerk (Hybrid)
Optum
Addison, TX
10.2019 - 08.2020
- Coordinated billing processes, resulting in timely and accurate invoicing for services rendered.
- Reviewed insurance claim forms for accuracy and completeness, implementing necessary corrections to minimize errors.
- Maintained current working knowledge of CPT and ICD-10 codes, required modifiers, and encounter data.
- Performed electronic dental claims submission and corrected claims appearing on Edit Reports.
- Audited and corrected billing and posting documents for accuracy.
- Reduced billing errors through consistent review and reconciliation of account discrepancies.
- Entered data, used OBH facets and Laboratory Pathology Reports for processing and reconciliation of billing information on scanned documents.
- Data entry of all required billing information that appears on requisitions and laboratory reports.
- Organized financial accounts for audit preparation and review. for financial audits and supported audit process.
- Worked with multiple departments to check proper billing information.
- Utilized various software programs to process customer payments.
- Processed and managed imaging documentation, ensuring compliance with regulatory standards and enhancing documentation accuracy.
- Identified errors in scanned images and took corrective action.
Education
High School Diploma -
John Jay High School
San Antonio, TX06-1992
Some College (No Degree) - Cyber Security
Northwest Florida State College
Niceville, FL12-2027
Some College (No Degree) - Business Administration
Austin Community College
Austin, TXSkills
- Client management
- Data analysis
- Software proficiency
- Problem-solving skills
- Effective time management
- Team leadership
- Collaborative teamwork
- Conflict resolution
Certification
Federal Emergency Management Agency (FEMA)
Timeline
Claims Representative Associate (Remote)
Optum
11.2023 - Current
Direct Processor (Remote)
Caliber Home Loans
09.2020 - 10.2023
Billing Coordinator/Assoc Imaging Clerk (Hybrid)
Optum
10.2019 - 08.2020
High School Diploma -
John Jay High School
Some College (No Degree) - Cyber Security
Northwest Florida State College
Some College (No Degree) - Business Administration
Austin Community College