Desa Webb
Fort Scott,Kansas
Summary
Proactive Senior Medical Claims Examiner with extensive experience in Medicare and Medicaid claims adjudication, including Dialysis, SNF, LTC, Home Health, Inpatient, and Outpatient claims. Skilled in clinical coding, provider contract analysis, and maintaining compliance with industry regulations. Strong critical thinking, communication, and mentoring abilities, ensuring accurate and legitimate claims processing.
Overview
9
9
years of professional experience
Work History
Senior Medical Claims Examiner
Mphasis
03.2022 - Current
- Medicare and Medicaid claims adjudication.
- Dialysis, SNF, LTC, Home Health, Inpatient, Outpatient, Professional and Facility Claims.
- Medicare, Medicaid pricing for many states.
- Trained in Clinical Coding Expert for outpatient pricing.
- Skilled in reading provider contracts.
- Trained new examiners to process specific clients.
- Processing 250 daily on average.
Claims Examiner
Peak PACE Solutions
04.2019 - 03.2022
- Maintained compliance with industry regulations and company policies while evaluating medical claims for accuracy and legitimacy.
- Professional and Facility Claims adjudication including Dialysis, SNF, LTC, Home Health, Inpatient and Outpatient claims
- Skilled in Medicare and Medicaid pricing for many states.
- Processed 300+ claims per day on average.
Claims Examiner
First Source Solutions
06.2015 - 04.2019
- Utilized analytical skills to evaluate medical bills for accuracy and appropriateness of charges before approving payments as part of the claims process.
- Claims adjudication for HCFA claims with a focus on behavioral health claims.
- Data Entry
- Processed 400+ claims daily on average.
Education
GED -
Fort Scott High School
Fort Scott, KS06-2000
Skills
- Strong Communication Skills
- Critical Thinking Capacity
- HIPAA compliance awareness
- Claims Processing Proficiency
- Remote work
- Continuous Improvement Mindset
- ICD-10-CM Familiarity
- CPT Code Understanding
- Training and Mentoring Experience
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
I have not failed. I’ve just found 10,000 ways that won’t work.
Thomas Edison
Timeline
Senior Medical Claims Examiner
Mphasis
03.2022 - Current
Claims Examiner
Peak PACE Solutions
04.2019 - 03.2022
Claims Examiner
First Source Solutions
06.2015 - 04.2019
GED -
Fort Scott High School
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