Evelyn Patton
Cincinnati,OH
Summary
Diligent and meticulous Medical Claims Processor with 15+ years of experience accurately reviewing, processing, and resolving medical claims. Proficient in navigating complex insurance policies, ensuring compliance with regulatory standards, and resolving discrepancies efficiently. Adept at maintaining high productivity levels while upholding quality standards, resulting in streamlined claims processing and client satisfaction.
Overview
2024
2024
years of professional experience
1
1
Certification
Work History
Medical Billing and Coding
Nashville Pain Center
- Conducted accurate medical coding and billing procedures utilizing ICD-10, CPT, and HCPCS Level II codes, ensuring compliance with healthcare regulations and standards
- Managed patient accounts, including verifying insurance coverage, processing claims, and resolving billing discrepancies
- Participated in cross-functional teams to develop and implement strategies for revenue enhancement, cost containment, and process improvement initiatives
- Uphold confidentiality of patient information and adhered to HIPAA guidelines throughout the coding and billing process to safeguard sensitive medical data
Medical Claims Processor
Elevance Health
07.2017 - 12.2023
- Reviewed and processed over one hundred medical claims daily with an elevated level of accuracy and diligence
- Resolved 95% of claim discrepancies within 48 hours, ensuring timely reimbursement and customer satisfaction
- Communicated effectively with insurance companies, healthcare providers, and patients to clarify claim details and facilitate resolution
- Maintained 100% accuracy in data entry and claim tracking using industry software, resulting in streamlined processes and reduced processing times
- Prepared reports and analytics on claim processing metrics and performance indicators for management review
- Collaborated with team members to implement process improvements, resulting in a 15% increase in claim processing efficiency
- Stayed current with medical coding guidelines and regulations to ensure compliance with billing requirements and minimize claim denials
- Provided training and mentorship to new team members to promote proficiency in claim processing tasks
Education
Associate in Science - Business Information Systems
Sinclair Community College
Mason, OH08.2017
Skills
- Medical Billing & Coding
- Claims Handling
- Customer Service
- Problem-Solving
- Communication
- Analytical
- Leadership
- Meticulous
- Interpersonal
- Computer Competencies
Certification
Medical Coding Certification, Kaplan Career Institute, Nashville, TN, 09/01/09
Timeline
Medical Claims Processor
Elevance Health
07.2017 - 12.2023
Medical Billing and Coding
Nashville Pain Center
Associate in Science - Business Information Systems
Sinclair Community College
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