Dashaundra Moton
Dallas,TX
Summary
Detailed Claims Processor with a strong Customer Service background years of experience investigating claim information for correctness and providing top tier knowledge to members and patients. Trustworthy teammate with benefit knowledge and rapport-building skills. Noted for thoroughness and ethical customer service.
Overview
6
6
years of professional experience
Work History
Claims Processor/Member Service Representative
Health Equity And Leadership Conference
11.2021 - Current
- Reviewed and verified insurance policy information to assess coverage and determine appropriate claims processing procedures.
- Processed a high volume of incoming claims in accordance with established policies and procedures.
- Adhered to all applicable laws, regulations, and company standards while processing claims.
- Evaluated the validity of assigned claims by verifying that services are medically necessary according to established guidelines.
- Research and respond to telephone and written inquiries from our customers to ensure timely resolution of issues
- Educate customers on HealthEquity products such as eligible IRS expenses, Health Savings Accounts (HSA) investment and pricing options, Flexible Spending Accounts (FSA), Dependent Care, Transportation and claims processing procedures
- Maintained a high level of accuracy and efficiency in posting reimbursement transactions, payments, adjustments, manual denials, insufficient fund checks/debit transactions
Registration Representative
Golden Cross clinic (Methodist Hospital)
Dallas, TX
08.2018 - 06.2021
- Reviewed patient information and verified accuracy of demographic data in order to register patients.
- Assisted with scheduling appointments, verifying insurance coverage, and collecting payments.
- Provided excellent customer service by answering inquiries and resolving any issues that arose.
- Entered all patient information into the registration system accurately and efficiently.
- Performed accurate cash handling procedures for copayments, deposits, and other transactions.
- Verified patient eligibility for services through various online systems or by calling the insurance companies directly.
- Conducted thorough reviews of payment discrepancies, utilizing research and resolution techniques to minimize inappropriate deviations from expected reimbursement. Processed payments along with refunds and adjustments as needed.
- Processed referrals and entered claims and supporting claim documents to the appropriate parties for procedures and surguries
Education
High School Diploma -
Dallas Can Academy
Dallas, TXSkills
- Claims review
- Payments posting
- Transactions reconciliation
- Accuracy and Precision
- Basic bookkeeping and general business procedures
- Written and verbal communication skills
- Proficient in using Microsoft Word, Excel, PowerPoint, and internet research
- Strong problem solving and decision making skills
- Customer Service
- Data Entry
- Medical terminology knowledge
- Billing rules and regulations
Timeline
Claims Processor/Member Service Representative
Health Equity And Leadership Conference
11.2021 - Current
Registration Representative
Golden Cross clinic (Methodist Hospital)
08.2018 - 06.2021
High School Diploma -
Dallas Can Academy
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