Denise Mackey
Dallas,TX
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
15
15
years of professional experience
Work History
Claims Associate
State Farm
11.2023 - 04.2024
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Assisted in onboarding of new claims processors to familiarize with company procedures, policies and processes.
- Verified client information by analyzing existing evidence on file.
- Collaborated with claims department and industry anti-fraud organizations to resolve claims.
- Utilized specialized software to process incoming claims, enter data and generate reports.
Medical Claims Specialist
RemX
02.2021 - 10.2023
- Evaluated pending claims to identify and resolve problems blocking auto-adjudication.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Stayed current on HIPAA regulations, benefits claims processing, medical terminology and other procedures.
- Reviewed administrative guidelines whenever questions arose during processing of claims.
Benefit Advisor
Benefit Harbor
07.2017 - 01.2021
- Coordinated benefits processing, including enrollments, terminations and claims.
- Mastered state and Federal benefit laws Including ERISA, FMLA, COBRA, HIPPA and 401k administration.
- Provided assistance to plan participants by explaining benefits information to ensure educated selections.
- Negotiated collective agreements on behalf of employers or workers and mediated labor disputes and grievances.
Senior Accounts Payable Clerk
Hutton Communications
05.2013 - 07.2017
- Prepared and processed payrolls.
- Handled high-volume invoice processing with minimal supervision.
- Implemented program to create daily spreadsheets and streamline financial reporting.
- Interfaced and responded to inquiries to correct accounts payable discrepancies.
- Kept detailed records of accounts payable by creating reports and updating vendor balance sheets.
Customer Service Advocate
Connextions
10.2009 - 05.2013
- Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations.
- Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills.
- Entered data into spreadsheets, documents and databases with high accuracy rate.
- Answered to members inquiries regarding prescription drug coverage.
Education
High School Diploma -
T. Davis Independent School
Skills
- Coverage Determination
- Policy Modifications and Updates
- Premium Collection
- New Policies Processing
- Data Entry
- Eligibility Determination
- Open Enrollment
- Employee Benefits Practices
- ACA Standards Knowledge
- Microsoft Office
- Call Documentation
- HIPPA
- Collaborative relationships
- Team building
- Excellent administrative abilities
Timeline
Claims Associate
State Farm
11.2023 - 04.2024
Medical Claims Specialist
RemX
02.2021 - 10.2023
Benefit Advisor
Benefit Harbor
07.2017 - 01.2021
Senior Accounts Payable Clerk
Hutton Communications
05.2013 - 07.2017
Customer Service Advocate
Connextions
10.2009 - 05.2013
High School Diploma -
T. Davis Independent School
Similar Profiles
ALBERTO ESCOBAR RUIZALBERTO ESCOBAR RUIZ
Claim Specialist; and Producer at State Farm Corporate & State Farm AgencyClaim Specialist; and Producer at State Farm Corporate & State Farm Agency
Bethany GandyBethany Gandy
Insurance Customer Service Specialist at Brian Moore State Farm & Brent Holman State FarmInsurance Customer Service Specialist at Brian Moore State Farm & Brent Holman State Farm
Blake EnosBlake Enos
Underwriting Service Assistant at State FarmUnderwriting Service Assistant at State Farm
Hadiya HullHadiya Hull
Claims Adjuster at State FarmClaims Adjuster at State Farm
Giovani GonzalezGiovani Gonzalez
Electronic/IT Technician at Move SolutionsElectronic/IT Technician at Move Solutions