Debra Burr

Perform and complete assigned tasks by end of business week.

Trained in several data include Concuity/ Host/ PTAC / Epic/ eRequest/ eCare.

Coordinate communication necessary for documentation alignment to the appropriate work steams.

Analyzes documentation for new automatons and existing automations.

Performs independent review of training documentation to ensure that the outcome accurately reflects the documentation Process.

Maintaining First Level Review application resource to ensure accurate review detail comments

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Prepared detailed reports on control findings and recommended corrective actions for senior management''s review and approval.

Resolved complex claims issues by analyzing documentation and ensuring compliance with company policies.

Streamlined claims processing workflows, improving efficiency and accuracy in case handling.

Monitor insurance claims and contact insurance companies to resolve claims.

Identify coding or billing errors from EOBs and work to correct them.

Adjusted claims for appropriate writes off up to $2500 .

Assigned to Child Safety claims to communication with provider and NC state to resolve Medicaid claims with strict access is sensitive information in The State of North databases.

Analyzed complex claims to ensure compliance with regulatory guidelines and company policies.

Reviewed and processed high volumes of claims efficiently, maintaining accuracy and consistency in outcomes.

Collaborated with cross-functional teams to resolve discrepancies and improve claims processing workflows.

Processed 200+ a day in Medicare and Medicare Advantage Plans with accurate quality.