DanNisha Taylor
Louisville,KY
Summary
Experienced medical claims specialist with strong analytical skills, adept at managing complex claim processes and ensuring compliance with industry regulations. Focused on team collaboration and achieving results, consistently adapting to changing needs. Skilled in claims adjudication, customer service, and detailed documentation. Reliable and driven to contribute effectively in fast-paced environments.
Overview
8
8
years of professional experience
Work History
Medical Claims Representative
Molina Healthcare
05.2023 - Current
- Increased efficiency by accurately entering provider data into company systems and databases.
- Educated providers on billing procedures, coding guidelines, and reimbursement policies for optimal claim submissions.
- Provide expertise or general claims support by reviewing, researching, and processing claims.
- Reduced claim processing time by implementing efficient workflow strategies and prioritizing tasks effectively.
Claims Service Representative
Anthem
02.2021 - 04.2023
- Managed and resolved customer claims, ensuring a high level of customer satisfaction.
- Investigated and evaluated claims to determine coverage and liability.
- Maintained accurate and up-to-date claim files and documentation.
Accounts Receivable Clerk
Houchens Industries Inc. IGA
05.2017 - 02.2021
- Prepared and mailed invoices to customers, processed payments, and documented account updates.
- Submitted cash and check deposits and generated cash receipts to record money received.
- Used accounting software to reconcile accounts, track income, and generate invoices.
Education
High School Diploma -
Central High School
Louisville, KY01.2014
Skills
- Claims processing
- Medical billing
- Medical software
- Claim adjustments
- Customer service
- Insurance claims processing
- Medical terminology
- Knowledgeable in [CAS, Salesforce, Cotiviti, Optum, AS1400, Microsoft Excel]
- Data Entry
- ICD codes
LANGUAGES
English
Native
Timeline
Medical Claims Representative
Molina Healthcare
05.2023 - Current
Claims Service Representative
Anthem
02.2021 - 04.2023
Accounts Receivable Clerk
Houchens Industries Inc. IGA
05.2017 - 02.2021
High School Diploma -
Central High School