Elaine Williams
Lee's Summit
Summary
As claims professional, consistently delivered high-quality evaluations and resolutions for insurance claims. Known for thorough investigations and effective communication with stakeholders. Collaborative team player with results-driven mindset, adaptable to changing requirements and dedicated to achieving optimal outcomes.
Overview
20
20
years of professional experience
Work History
Health Claim Examiner II
DST Health Solutions
08.2017 - Current
- Reviewed and analyzed claims for accuracy, ensuring compliance with company policies.
- Collaborated with healthcare providers to gather necessary documentation for claim processing.
- Reduced claim processing time by streamlining workflow and prioritizing tasks efficiently.
- Investigated discrepancies in claims to identify issues and facilitate timely resolutions.
Medical Records Coordinator
Interim HealthCare
05.2016 - 07.2016
- Entered new Start of Cares into new system and scheduled visits for clinicians. Verified Visits and Missed Documents Reports. Entered meeting times into system for billing. Answered phones and filed.
Medical Billing Specialist
Cerner Corporation
04.2015 - 04.2016
- Managed end-to-end medical billing processes, ensuring compliance with regulatory standards.
- Collaborated with healthcare providers to clarify and obtain necessary documentation for claims processing.
- Coordinated with insurance companies to facilitate timely reimbursements and resolve payment disputes.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Located errors and promptly refiled rejected claims.
- Identified and resolved patient billing and payment issues.
Medical Records Coordinator/Medical Office Clerk
Lincare
06.2014 - 03.2015
- Maintained patient confidentiality by adhering to HIPAA regulations and organizational policies.
- Managed medical record requests, ensuring compliance with HIPAA regulations.
- Completed data entry tasks with accuracy and efficiency.
- Followed established procedures to enter and process data correctly.
- Entered data into various computer systems accurately using Microsoft Office Suite.
- Coordinated patient data entry and maintained accurate electronic health records.
Insurance Specialist/Medical Biller
Global Medical Direct
11.2011 - 10.2013
- Processed insurance claims; Medicaid, Medicare and Professional Insurance Applied and Posted payments, worked rejections Verified Insurance and answered phones
- Processed eligibility and benefits verification and authorization requests.
- Followed up on denials, late payments, extensions and other special circumstances.
- Resolved discrepancies in insurance payments by collaborating with carriers.
- Responded to customer calls swiftly to resolve issues and answer questions.
- Verified insurance of patients to determine eligibility.
Order Entry Specialist
Rockhill Pharmacy
02.2010 - 08.2011
- Uploaded physician progress notes, history, and physicals into electronic medical records.
- Reviewed charts and flagged incomplete or inaccurate information.
- Established strong relationships with insurance companies and other external partners involved in processing claims or accessing patient information.
- Supported medical staff by providing organized and accurate medical records.
- Managed medication dispensing processes, ensuring accuracy and compliance with pharmacy regulations.
- Enhanced pharmacy workflow by assisting pharmacists with medication dispensing, labeling, and packaging.
Medical Biller
Grace Weekend Clinic
05.2009 - 01.2010
- Processed insurance claims; Medicaid, Medicare and Professional Insurance Applied and Posted payments, worked rejections
Medical Records Specialist/Returns Clerk
Omnicare Pharmacy
03.2005 - 07.2008
- Updated patient records with current physician orders Credited returned items and restocked shelves
Education
Associate of Applied Science - Health Information Technology
National American University
Rapid City, SD02.2016
Diploma - Medical Billing and Coding
Pinnacle Career Institute
North Kansas City, MOCertificate - CPC
AAPC
07-2025
Skills
- Interpretation of regulations
- Effective team collaboration
- Client support
- Effective time management
- Detail-oriented
- Proficient in managing multiple tasks
- Claims investigation
Timeline
Health Claim Examiner II
DST Health Solutions
08.2017 - Current
Medical Records Coordinator
Interim HealthCare
05.2016 - 07.2016
Medical Billing Specialist
Cerner Corporation
04.2015 - 04.2016
Medical Records Coordinator/Medical Office Clerk
Lincare
06.2014 - 03.2015
Insurance Specialist/Medical Biller
Global Medical Direct
11.2011 - 10.2013
Order Entry Specialist
Rockhill Pharmacy
02.2010 - 08.2011
Medical Biller
Grace Weekend Clinic
05.2009 - 01.2010
Medical Records Specialist/Returns Clerk
Omnicare Pharmacy
03.2005 - 07.2008
Associate of Applied Science - Health Information Technology
National American University
Diploma - Medical Billing and Coding
Pinnacle Career Institute
Certificate - CPC
AAPC
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