Imani Collins
Roselle,NJ
Summary
Results-driven Senior Medical Claims and Support Specialist at ConnectiveRx with expertise in claims processing and benefits verification. Adept at training and development, fostering team collaboration, and enhancing patient relationships, ensuring high retention rates and satisfaction. Consistent in developing strategies to reduce claim processing times and producing one-call resolutions for escalations.
Overview
4
4
years of professional experience
Work History
Senior Claims and Support Specialist
ConnectiveRx
03.2024 - Current
- Handled sensitive information with discretion, ensuring confidentiality of personal and financial details for claimants throughout the claims examination process.
- Utilized analytical skills to evaluate medical bills for accuracy and appropriateness of charges before approving payments.
- Reduced claim processing time by implementing efficient workflow strategies.
- Reviewed CMS 1500 forms, UB-04 forms, itemized explanation of benefits, authorization forms and additional documents in order to determine claim eligibility.
- Conducted claims and patient support trainings for new hires and active employees in need of additional assistance.
- Escalated claims that included adverse events.
- Provided claim status and updates to health care providers, specialty pharmacies, patients and insurance carriers.
Patient Enrollment Specialist
Anthem Inc.
10.2020 - 10.2023
- Ensured successful onboarding of new patients and managed their experience after onboarding.
- Demonstrated the functions and utilization of Carelon services to patients based on their individual needs.
- Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from patients.
- Managed escalated customer issues, ensuring swift resolution and maintaining positive relationships with patients.
- Educated patients on the options available to them regarding their pharmacy care and medication adherence.
- Troubleshooted issues with pharmacy management and activation team.
- Boosted morale within the team by organizing engaging team-building activities and encouraging open communication among peers.
- Maintained detailed documentation of support interactions, follow up outcomes, and activation statuses.
Education
Bachelor of Arts - Political Science
Fairleigh Dickinson University
Madison, NJ05-2020
Skills
- Claims analysis
- Payment processing
- ICD10 coding systems
- CPT and procedure coding
- Microsoft Office
- Training and development
Timeline
Senior Claims and Support Specialist
ConnectiveRx
03.2024 - Current
Patient Enrollment Specialist
Anthem Inc.
10.2020 - 10.2023
Bachelor of Arts - Political Science
Fairleigh Dickinson University
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