India Morgan
Beaumont,TX
Summary
Dynamic Insurance Claims Specialist with proven expertise at First Health in claims analysis and customer service. Adept at enhancing operational efficiency through meticulous documentation and effective teamwork. Skilled in policy interpretation and insurance coverage verification, ensuring compliance and accuracy in high-volume environments. Committed to fostering client relationships and streamlining claims processes.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Insurance Claims Specialist
First Health
Houston, TX
04.2023 - Current
- Reviewed and validated insurance claims documentation for completeness and accuracy.
- Facilitated customer navigation through claim procedures and requirements.
- Oversaw meticulous record-keeping of claims to ensure adherence to company policies.
- Facilitated collaboration among team members to enhance claims processing workflows.
- Addressed minor claim discrepancies by facilitating effective communication between clients and adjusters.
- Facilitated administrative support during peak periods to ensure timely claim resolution.
- Collaborated with claims adjusters and examiners to streamline processing in accordance with established procedures.
- Cultivated client relationships through effective communication during the claims process, ensuring all stakeholders remained informed of progress and outcomes.
Insurance Verification Specialist
Southwest Memorial Hermann Hospital
Houston, TX
06.2019 - 03.2023
- Verified patient insurance coverage and eligibility for medical services.
- Spearheaded strategic partnerships with healthcare providers to streamline acquisition of essential pre-authorizations.
- Evaluated and validated insurance claims to ensure compliance with industry regulations.
- Rectified discrepancies in insurance information and patient records with precision and thoroughness.
- Spearheaded collaboration with billing department to enhance revenue cycle efficiency.
- Facilitated training sessions for new staff on insurance verification procedures and best practices.
- Led compliance initiatives to ensure adherence to HIPAA regulations and maintain privacy standards.
- Streamlined verification processes for insurance benefits prior to patient procedures and appointments.
- Facilitated effective communication between medical staff and patients to clarify insurance benefits and financial responsibilities.
- Facilitated team collaboration to identify and resolve discrepancies in insurance verification processes.
- Oversaw high-volume insurance verification processes to optimize operational efficiency in medical services.
- Optimized claim processing efficiency by conducting comprehensive verification of insurance coverage and obtaining pre-authorizations for procedures.
Pharmacy Technician
Walgreens
Houston, TX
05.2015 - 07.2019
- Administered and dispensed medications with precision, adhering to prescriptions and established protocols.
- Facilitated inventory management for pharmacists, ensuring optimal medication availability and regulatory compliance.
- Instructed patients on appropriate medication usage and potential side effects to promote informed health decisions.
- Ensured cleanliness and organization of work environment to promote safety standards and operational efficiency.
- Oversaw prescription order accuracy, identifying and resolving discrepancies proactively.
- Managed incoming phone calls, providing timely responses to inquiries from customers and healthcare providers.
- Optimized workflow processes to enhance operational efficiency within pharmacy department.
- Managed stocking, labeling, and inventory of medications to ensure accurate record-keeping.
- Streamlined pharmacy workflow by optimizing medication dispensing, labeling, and packaging processes.
- Executed precise calculations for dosage, ensuring accurate prescription fulfillment.
- Ensured patient confidentiality by strictly adhering to HIPAA regulations during personal information transactions.
Education
Pharmacology
The College of Health Care Professions
TX05.2015
High School Diploma -
Westbury High School
Houston, TX05.2009
Skills
- Claims investigation
- Claims analysis
- Policy interpretation
- Teamwork and collaboration
- Customer service
- Attention to detail
- Data entry
- Organizing and prioritizing work
- Insurance coverage verification
- Claims adjustment
- Documentation skills
- Policy analysis
- Recordkeeping organization
- Policy review
- Coverage determination
- Eligibility determination
- Medical terminology
- New policies processing
Certification
Bls
Timeline
Insurance Claims Specialist
First Health
04.2023 - Current
Insurance Verification Specialist
Southwest Memorial Hermann Hospital
06.2019 - 03.2023
Pharmacy Technician
Walgreens
05.2015 - 07.2019
Pharmacology
The College of Health Care Professions
High School Diploma -
Westbury High School