Gavin Windes

• Designed and delivered high-quality marketing collateral, including brochures, logos, and social media content.

• Partnered with clients to ensure brand consistency and alignment with visual standards.

• Coordinated multiple projects simultaneously, consistently meeting deadlines with precision.

• Reviewed, validated, and processed encounter data submissions to ensure accuracy and compliance with state and federal regulations.
• Conducted data analysis to identify trends, gaps, and discrepancies, implementing corrective actions to improve data quality.
• Collaborated with internal teams to align encounter data with billing, claims, and reporting requirements.
• Prepared detailed reports and presentations for senior management, summarizing data insights and compliance statuses.
• Developed and maintained documentation for data submission processes, including workflows and troubleshooting guides.
• Partnered with IT teams to enhance data systems, ensuring seamless integration and reporting capabilities.

• Processed a high volume of medical claims, ensuring accuracy and compliance with company policies and insurance guidelines.
• Reviewed and verified patient information, treatment codes, and claim details to resolve discrepancies efficiently.
• Collaborated with healthcare providers to address claim adjustments and appeals.
• Calculated payments due based on allowed charges compared to billed charges according to contract terms with payers, insurers, third parties.
• Identified potential fraud cases based on analysis of submitted claims data and escalated accordingly.