Janet Lima
Miami
Summary
I am seeking to obtain employment with a company, which I can utilize my skills and have the opportunity to grow within the company.
Overview
27
27
years of professional experience
Work History
Claims Auditor
Integrated Healthcare Services
Miramar
10.2024 - Current
- Reviewed insurance claims for accuracy and compliance with regulations.
- Analyzed claim documentation to identify discrepancies and validate data integrity.
- Collaborated with healthcare providers to clarify claim details and resolve issues.
Medical Billing Director
JML Professional Medical Services Inc
Miami
04.2010 - 10.2024
- Oversaw medical billing operations to ensure compliance with regulations and standards.
- Analyzed billing data to identify trends and improve accuracy in claims submission.
- Collaborated with management on strategic planning for revenue cycle enhancement.
Claims Examiner Supervisor
Coventry Health Care
Sunrise
07.1999 - 04.2010
- Collaborated with healthcare providers to gather necessary information for claims.
• Claims Adjustments
- Evaluated claims for accuracy and compliance with company policies.
- Reviewed medical documentation to determine claim eligibility and benefits.
- Resolved discrepancies by communicating effectively with internal teams and clients.
- Implemented best practices to streamline the claims processing workflow.
Education
Associate of Science - Business And Accounting
Essex County College
Newark, NJSkills
Claims Examiner & Adjustments
Claims Auditor
Credentialing
Management
Customer Service
Organized & Motivated
Billing & Collection
References
References available upon request.
Timeline
Claims Auditor
Integrated Healthcare Services
10.2024 - Current
Medical Billing Director
JML Professional Medical Services Inc
04.2010 - 10.2024
Claims Examiner Supervisor
Coventry Health Care
07.1999 - 04.2010
Associate of Science - Business And Accounting
Essex County College