Julicia Minor
Houston,TX
Summary
Analytical Claims Specialist with proven experience investigating and resolving property, health and business claims. Delivers professional and balanced customer service and meets needs of insured, claimant and internal and external customers. Insurance expert with exceptional knowledge of legal liabilities and claims practices and superior interpersonal skills.
Overview
10
10
years of professional experience
Work History
Medicaid Claims Specialist
Aetna
Houston, TX
07.2014 - 07.2019
- Reviewed and analyzed insurance claims to determine validity, completeness, accuracy, and eligibility for payment.
- Researched medical records to evaluate claim validity and verify the existence of pre-existing conditions.
- Facilitated communication between claimants, providers, attorneys, adjusters, employers, and other parties involved in a claim.
- Assisted with filing appeals on denied claims with insurance companies.
Insurance Follow-Up Specialist
Pfsgroup
Houston, TX
02.2024 - 04.2024
- Reviewed patient accounts and updated insurance information in the system.
- Processed claims for payment according to established procedures.
- Followed up with insurance carriers regarding claim status of unpaid or rejected claims.
- Maintained professional relationships with various insurance companies while advocating on behalf of the organization's interests.
- Utilized multiple payer websites to obtain detailed information about benefit eligibility and coverage levels.
- Ensured that all documentation was accurate and complete prior to submitting claims for payment consideration by the insurance company.
Insurance Verification Specialist
Preventive Services/Search Services
Houston, TX
- Verified patient eligibility for insurance coverage by contacting insurance carriers and obtaining the necessary authorization numbers.
- Developed a working knowledge of insurance plans, including Medicare and Medicaid regulations and requirements.
- Provided timely follow up with payers regarding payment status of claims.
- Processed manual claims when necessary due to incorrect or incomplete information from providers or patients.
- Evaluated policies and procedures related to Insurance Verification activities.
Education
High School Diploma -
Kashmere High School
Houston, TX06-1990
Skills
- Insurance Claims Review
- Coverage Determination
- Claims Processing Documentation
- Policy Coverage Determinations
- Claims Management
- Claims Review
- Team Collaboration
- Documentation Skills
Timeline
Insurance Follow-Up Specialist
Pfsgroup
02.2024 - 04.2024
Medicaid Claims Specialist
Aetna
07.2014 - 07.2019
Insurance Verification Specialist
Preventive Services/Search Services
High School Diploma -
Kashmere High School
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