Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Joyce Harmon

Killeen,TX

Summary

Experienced Claims Specialist with 3 years in claims management and customer support, adept at documentation review and ensuring compliance with HIPAA and regulatory standards. Proven ability to process and resolve insurance claims efficiently, delivering high-quality service and policyholder satisfaction. Seeking Claims Specialist role to leverage expertise in case management and data accuracy. Skilled in interviewing, records searching and documentation. Excellent critical thinking and organizational abilities. Proficient in insurance policy coverage levels, industry practices and compliance requirements.

Overview

10
10
years of professional experience
1
1
Certification

Work History

LOA Coordinator

Sedgwick CMS
05.2024 - 11.2024
  • Maintain strict adherence to HIPAA guidelines to protect confidential patient information during documentation and communication processes
  • Accurately record claim details in alignment with organizational protocols, ensuring consistency and quality in case management
  • Make informed and prompt case decisions, effectively communicating outcomes and expectations to claimants and clients
  • Updated HR databases with current information related to employees' leaves of absences.
  • Coordinated return-to-work activities for employees returning from a leave of absence.

Claims Assistant

Sedgwick CMS
12.2022 - 05.2024
  • Processed and assembled claims documentation, coordinating with healthcare providers to obtain necessary medical records
  • Maintained strict adherence to HIPAA guidelines, ensuring the confidentiality and accuracy of patient information in all documentation
  • Complied with a comprehensive range of federal, state, and corporate regulations governing claims processing and data management
  • Managed data transcription, worksheet preparation, and computer entry for document creation and account adjustments, while actively resolving information discrepancies through direct communication

Claims Specialist

Allstate Insurance
06.2022 - 10.2022
  • Assessed and processed insurance claims with a focus on comprehensive documentation review, ensuring accuracy and completeness before proceeding with claim resolution
  • Delivered customer support by addressing inquiries, clarifying coverage specifics, and resolving disputes to uphold policyholder satisfaction
  • Guided new Claims Specialists through training on departmental procedures and best practices, enhancing team proficiency and service quality

Certified Nursing Assistant

Advent Health
Killeen, USA
09.2019 - 03.2021
  • Delivered direct patient care, ensuring compliance with nutritional guidelines and monitoring dietary intake
  • Assisted in patient mobility by facilitating transfers, organizing wheelchairs, and preparing mobility aids for individuals with respiratory and muscular disorders
  • Responded to patient calls promptly, maintained safety by adjusting bedrail's and equipment, and recorded vital signs for personalized care

Caregiver

Legacy Oaks of Lakeway
Lakeway, USA
05.2018 - 02.2019
  • Delivered empathetic care to individuals with Alzheimer's Dementia, enhancing daily living activities to maintain personal dignity and well-being
  • Assisted in nutritional management by supporting mealtime routines and monitoring dietary intake to ensure alignment with health objectives

Certified Nursing Assistant

Promed Medical Staffing
Lafayette, USA
08.2014 - 01.2018
  • Provided nutritional support to patients by assisting with feeding and monitoring dietary intake to meet health goals
  • Facilitated patient mobility by aiding in transfers, arranging wheelchairs, and setting up assistive devices for accessibility
  • Conducted routine health assessments, including measuring temperature, blood pressure, and glucose levels, to ensure patient well-being

Certified Nursing Assistant

SWLA Veterans Home
Jennings, USA
06.2015 - 05.2016
  • Delivered comprehensive support for activities of daily living, including monitoring and recording vital signs and dietary intake to promote patient health and nutrition
  • Assisted with patient mobility, ensuring safe transfers and equipment readiness, while maintaining a clean and orderly environment in living areas and nursing stations to enhance patient comfort and safety

Education

Certificate - Medical Billing And Coding

CCI Training
Arlington, TX
08.2023

Certificate - Clinical Medical Assistant

Elite Nurse Aide Training
Killeen, TX
07.2021

Certificate - Nurse Assistant

Infinity College
Lafayette, LA
04.2013

High school diploma or GED - General Studies

SWLA Technical College
Lafayette, LA
05.2004

Skills

  • Detail-Oriented Analysis
  • Calm under stress
  • Effective Time Allocation
  • Multitasking and prioritization
  • Multi-Line Call Handling
  • Accurate Data Entry
  • Microsoft Office
  • Willingness to Learn
  • Documentation review
  • Data collection
  • EMR Systems
  • Patient Records Management
  • Analytical skills
  • Decision making
  • Customer service
  • Problem Solving
  • FMLA Compliance Management
  • Claims management
  • FMLA regulations
  • Healthcare industry
  • Clinical Documentation
  • Collecting information
  • Document processing
  • Verifying data accuracy
  • Administrative support specialist
  • Task coordination
  • Workday System Navigation
  • Leave Management

Certification

  • CPR Certification
  • BLS Certification
  • First Aid Certification

Timeline

LOA Coordinator

Sedgwick CMS
05.2024 - 11.2024

Claims Assistant

Sedgwick CMS
12.2022 - 05.2024

Claims Specialist

Allstate Insurance
06.2022 - 10.2022

Certified Nursing Assistant

Advent Health
09.2019 - 03.2021

Caregiver

Legacy Oaks of Lakeway
05.2018 - 02.2019

Certified Nursing Assistant

SWLA Veterans Home
06.2015 - 05.2016

Certified Nursing Assistant

Promed Medical Staffing
08.2014 - 01.2018

Certificate - Medical Billing And Coding

CCI Training

Certificate - Clinical Medical Assistant

Elite Nurse Aide Training

Certificate - Nurse Assistant

Infinity College

High school diploma or GED - General Studies

SWLA Technical College

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Joyce Harmon