Christopher D Charlemagne
Carrollton,TX
Summary
Focused Claims Examiner skilled in managing large client caseloads across full lifecycle claim processes. Recognize up selling opportunities to increase department revenue. Builds rapport with customers and insurers to negotiate positive case outcomes.
Overview
5
5
years of professional experience
Work history
Claims Examiner
Gainwell Technologies Remote
Irving
04.2019 - Current
- Responsible for approximately 10-50 daily cases- Medicare and Health Insurance with different assigned States (Domestic)
- Worked proficient with Teams, and other internal software (Maestro)
- Reviewed all incoming cases for inaccuracy
- Worked independently and with a team to meet business objectives
- Skilled in making informed decisions based on expertise and agreed procedures
- Strong focus on client satisfaction and delivering relevant services
- Proficient in reviewing and assessing ongoing claims, interacting with stakeholders
- Offer support, guidance, and expertise in policy challenges, negotiations, and maintaining collaborative relationships
- Dedicated to providing the highest level of service and meeting client needs
Patient Care Specialist
AllianceRx Walgreens Prime
Frisco
11.2018 - 04.2019
- Maintained a high level of confidentiality and ethics in relation to HIPAA and PHI laws
- Enter detailed information into the company's proprietary software
- Responsible for approximately 10-50 inbound/outbound calls per day
- Maintained manual dexterity in the use of internal software Called
- Demonstrate the ability to determine needs and manage calls accordingly
- Worked proficient with Microsoft Suite, and other internal software
- Assisted with audit/reports on 6-10 Coordinators including compiling weekly reports
- Worked independently and with a team to meet business objectives
- Verified patient insurance coverage and benefits
Patient Intake Coordinator
Cardinal Health
Lewisville
07.2018 - 11.2018
- Responsible for approximately 10-50 inbound/outbound calls per day
- Enter detailed information into the company's proprietary software (HCN)
- Maintained manual dexterity in the use of internal software Called
- Worked proficient with Microsoft Suite, Salesforce, and other internal software
- Worked independently and with a team to meet business objectives
- Reviewed and audited all entered insurance coverage information for ordered services
- Maintained a high level of confidentiality and ethics in relation to HIPAA and PHI laws
- The ability to prioritize and resolve order issues including vendors-third party logistics to track lost or undelivered shipments and merchandise returns
Education
Health Information Technician -
Rasmussen University Ocala
Graphic Design
Northeast High School Philadelphia
06.2007
Skills
- Research skills
- Lender collaboration
- Microsoft Office Suite
- Casualty and Estates
- Negotiation and mediation skills
- Benefits review
- ClaimsPro
- Subrogation expert
- Healthcare Common Procedures Coding System (HCPCS)
- Insurance policy coverage knowledge
- Claims
Languages
French
Intermediate
Work availability
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
morning
afternoon
evening
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Timeline
Claims Examiner
Gainwell Technologies Remote
04.2019 - Current
Patient Care Specialist
AllianceRx Walgreens Prime
11.2018 - 04.2019
Patient Intake Coordinator
Cardinal Health
07.2018 - 11.2018
Health Information Technician -
Rasmussen University Ocala
Graphic Design
Northeast High School Philadelphia
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