Eukneique Allen
Evans,GA
Summary
Professional claims processing specialist with strong analytical skills and thorough knowledge of insurance policies and procedures. Proven ability to collaborate effectively within teams, meeting deadlines, and adapting to changing priorities. Skilled in data entry, document review, and customer service. Known for reliability and achieving results in fast-paced environments.
Overview
11
11
years of professional experience
Work History
Claims Processing Specialist
CVS Aetna
11.2022 - Current
- Maintained a high level of accuracy and attention to detail when reviewing submitted claims for completeness and correctness, contributing to the overall quality of processed claims.
- Provided ongoing training to new hires, improving overall team proficiency in claims processing tasks.
- Streamlined the appeals process for denied claims, resulting in faster resolution times for clients.
- Enhanced customer satisfaction with timely claim resolution through effective communication and followup.
- Collaborated with team members to ensure consistency in claims processing, resulting in reduced discrepancies.
- Managed high-volume workloads while maintaining strict deadlines for claim submissions and resolutions.
- Maintained up-to-date knowledge of industry regulations, ensuring accurate and compliant claims processing.
- Reduced claim errors by conducting thorough investigations and obtaining all necessary documentation.
Medical Claims Specialist
Convey Health Solutions
08.2017 - 10.2022
- Monitored outstanding accounts receivable balances for trends that could indicate payer issues or potential collection problems.
- Optimized workflow processes by identifying bottlenecks within the system, implementing necessary changes for increased efficiency.
- Collaborated with interdisciplinary teams to ensure smooth processing and accurate reimbursement of medical claims.
- Submitted electronic/paper claims documentation for timely filing.
- Reduced errors in claims submissions through meticulous attention to detail and thorough review processes.
- Achieved timely reimbursements for clients through keen understanding of insurance company protocols.
- Expedited claim resolution times with proactive communication between patients, providers, and insurance companies.
- Paid or denied medical claims based upon established claims processing criteria.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Calculated adjustments, premiums and refunds.
- Collected premiums and issued accurate receipts.
Data Entry Clerk
Change Healthcare
03.2014 - 05.2016
- Completed data entry tasks with accuracy and efficiency.
- Followed established procedures to enter and process data correctly.
- Checked for accuracy by verifying data and records.
- Prioritized tasks effectively to ensure timely completion of all assigned projects without sacrificing attention to detail.
- Followed data entry protocols, rules and regulations.
- Organized, sorted, and checked input data against original documents.
- Corrected data entry errors to prevent duplication or data degradation.
- Scanned documents and saved in database to keep records of essential organizational information.
- Communicated with supervisors and colleagues to process data quickly and resolve discrepancies.
- Updated and maintained customer information, documents and records.
- Managed documents by organizing forms, making photocopies, filing records, preparing correspondence, and creating reports.
Education
High School Diploma -
Miami Carol City Sr. High
Miami Gardens06-2013
Skills
- Claims processing software
- Verbal communication
- Medical terminology
- Data entry proficiency
- Research
- Insurance regulations
- Confidentiality
- Accuracy and precision
- Allocating claims
- Claims trend analysis
- Problem-solving
- Attention to detail
- Problem-solving abilities
- Multitasking
- Claims investigation
- Critical thinking
- Verbal and written communication
- Microsoft office
- Data entry
Timeline
Claims Processing Specialist
CVS Aetna
11.2022 - Current
Medical Claims Specialist
Convey Health Solutions
08.2017 - 10.2022
Data Entry Clerk
Change Healthcare
03.2014 - 05.2016
High School Diploma -
Miami Carol City Sr. High
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