Hannah Ursery
Garland,TX
Summary
Seasoned administrative team member with proficiency in customer relations, multitasking and making decisions with little oversight. Skilled at managing open claims, authoring correspondence and organizing case files. Seeking a dynamic position with room for growth.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Claims Assistant
State Farm
Richardson, TX
07.2023 - Current
- Provided customer service support to policyholders, claimants, and agents over the phone or via email.
- Prepared detailed documentation supporting all activities related to each claim processed.
- Participated in regular training sessions designed to keep up-to-date on industry laws and regulations pertaining to insurance claims handling practices.
- Maintained accurate records related to all aspects of the claims process.
- Performed data entry into internal systems to process claims requests.
- Managed incoming mail consisting of new applications and and or additional documentation required for existing open claims files.
- Performed quality control checks on completed files prior to final submission for payment authorization purposes.
- Answered inquiries from customers regarding their individual claims status.
- Investigated and resolved discrepancies in claims data entries.
- Assisted in the preparation of documents for claims processing.
- Processed payments for approved claims within specified time frames.
- Ensured compliance with HIPAA regulations when dealing with confidential patient information.
- Opened, sorted and monitored claims.
- Verified details with policyholders and requested additional information.
- Reviewed documentation and accounts to gain full picture.
- Interpreted and applied insurance policy provisions to determine coverage for each claim.
- Utilized claims management software to track claims progress and maintain organized documentation.
- Identified and pursued opportunities for subrogation to recover funds from third parties responsible for losses.
Authorizations Representative
Salience Health
Plano, TX
10.2020 - 07.2023
- Developed effective working relationships with other departments within the organization.
- Assisted with verifying insurance eligibility, coverage limits, and benefit plans.
- Maintained confidentiality of all patient related information at all times.
- Performed other duties as assigned by department manager or supervisor.
- Reviewed authorization requests to ensure accuracy of information prior to submission.
- Updated authorization tracking system with pertinent information on a daily basis.
- Processed and maintained patient authorizations for services rendered.
- Collaborated with medical staff to obtain necessary documentation for authorizations.
- Monitored the status of all pending authorizations and updated records accordingly.
- Responded to inquiries from patients, providers, and payers in a timely manner.
- Researched any issues that arose during the authorization process and provided solutions when needed.
- Managed and obtained insurance authorizations for patient referrals from physicians.
Pharmacy Technician Trainee
CVS HEALTH CORPORATION
Richardson, TX
03.2018 - 10.2020
- Managed multiple tasks simultaneously while maintaining a high level of accuracy and attention to detail.
- Verified insurance coverage for medications.
- Ensured compliance with state laws regarding controlled substances.
- Maintained patient profiles and medication records.
- Processed insurance claims for reimbursement purposes accurately and efficiently.
- Retrieved prescription requests from patients or healthcare providers via telephone or fax machine.
- Received written prescription or refill requests, verifying information for completeness and accuracy.
- Answered telephones to respond to questions or requests.
- Prepared and processed medical insurance claim forms and records.
Education
Garland High School
Garland, TX06-2016
Skills
- Analytical Problem Solving
- Decision-making capabilities
- Effective communication abilities
- Critical Decision-Making
- Insurance Verification
- HIPAA
- Claim validity determination
- Insurance claims management
- Insurance claims processing
- Conflict resolution techniques
Certification
- Claims Adjuster License
Timeline
Claims Assistant
State Farm
07.2023 - Current
Authorizations Representative
Salience Health
10.2020 - 07.2023
Pharmacy Technician Trainee
CVS HEALTH CORPORATION
03.2018 - 10.2020
Garland High School
- Claims Adjuster License
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