Damaris Wheaton

• Verified patient eligibility and benefits for insurance coverage by contacting insurance carriers and obtaining self-pay charges, co-insurance, deductibles, and authorization requirements/information.
• Interpreted Explanation of Benefits statements from various insurers, and submitted detailed reports on insurance verification activities and outcomes in easy-to-understand terminology for clients.
• Identified discrepancies in patient's insurance coverage or benefits, ensuring accuracy of data entered into system.
• Monitored and tracked the status of pending insurance verifications and authorizations.

• Reduced call wait times by efficiently managing call queues and prioritizing urgent requests.
• Maintained accurate patient records with diligent data entry and effective communication with healthcare professionals.
• Worked productively in fast-moving work environment to process large volumes of claims.
• Handled complex claim issues, effectively communicating with patients, providers, and insurance companies to ensure resolution.

• Enhanced claim processing efficiency by streamlining workflows and implementing best practices.

• Maintained compliance with industry regulations by adhering to established procedures and guidelines in claims handling.

• Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
• Provided exceptional customer service, addressing concerns and resolving issues promptly to maintain client satisfaction

• Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
• Handled customer inquiries and suggestions courteously and professionally.
• Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
• Enhanced patient satisfaction by efficiently addressing and resolving healthcare-related inquiries.

• Strengthened client relationships by providing clear communication throughout the claims process, ensuring all parties were well-informed of progress and outcomes.
• Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
• Maintained detailed records of all claim activities including correspondence, decisions, payments.
• Supported efficient handling of complex claims and followed up on open, denied, or suspended claims to complete required line items.