Julissa Webb
Palmetto,FL
Summary
Accomplished Senior Benefits Analyst with a proven track record at TriNet, enhancing data security and benefits administration through in-depth research and a continuous improvement mindset. Excelled in reducing claim denials and improving Medicaid eligibility determinations, showcasing strong communication skills and benefits administration expertise. Achieved significant process optimizations, demonstrating a commitment to excellence and results.
Overview
21
21
years of professional experience
Work History
Senior Benefits Analyst
TriNet
04.2015 - 06.2024
- Leveraged and integrated in-depth knowledge of benefit programs, technology and regulatory requirements for data security to provide business partners level advice and solutions.
- Delivered communication and training for benefit administrators on new plans and changes.
- Conducted regular audits of benefit plans, identifying areas for improvement and implementing necessary changes promptly.
- Implemented established procedures for day-to-day service and administration of benefit plans.
- Responsible for data entry based on employee online elections.
- life status change forms or benefit enrollment forms.
- Research and correct benefit enrollment issues and/or benefit carrier file discrepancies.
- Provided Tier II phone support. Processing medical support orders.
Medical Biller and Coder
Lung Associates P.A.
08.2003 - 04.2024
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Reduced claim denials through meticulous verification of patient eligibility and coverage benefits prior to claim submission.
- Worked closely with physicians to accurately assign ICD-10 diagnostic codes for optimal reimbursement rates from insurance companies.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
Medicaid Eligibility Specialist
Adreima
12.2007 - 04.2015
- Maintained up-to-date knowledge of relevant laws, regulations, and policy changes affecting Medicaid eligibility determinations.
- Improved customer service experience for applicants, providing clear explanations of eligibility requirements and addressing concerns promptly.
- Enhanced Medicaid eligibility determinations by thoroughly analyzing applicants'' financial and personal information.
- Resolved eligibility discrepancies by carefully reviewing regulations and collaborating with relevant parties to reach accurate determinations
- Reviewed referrals and screen for potential eligibility for state and Hospital financial assistance.
- Contacted patient or their representative ASAP to complete the application and acquire all necessary releases, signatures, documents (including the birth certificate), etc.
- Submitted the application and any acquired documentation in a timely manner to the appropriate agency.
- Data Entry in hospital and internal data base systems including Medicaid systems.
Medicare Set-a-side Advisor
Gould&lamb, LLC.
08.2003 - 04.2007
- Medicare and Workers Compensation research for all cases.
- Entered information into templates and insure all data is correct.
- Knowledge of case flow and due dates for completion in a timely manner.
- Updated Goldmine system with new data and figures.
- Requested information from outside sources via Letters and phone calls.
- Closed case files upon completion.
- Strong attention to detail. Complete MSA Summaries.
- Completed the calculations for future care needs
Education
Associates - Science - Health Administration
Keiser University
Fort Lauderdale, FL02.2024
Medical Coding And Billing
Manatee Technical College
Bradenton, FL08.2003
Skills
- Strong Communication Skills
- Benefits Administration Expertise
- Researching issues
- Continuous Improvement Mindset
Languages
Spanish
Native or Bilingual
Timeline
Senior Benefits Analyst
TriNet
04.2015 - 06.2024
Medicaid Eligibility Specialist
Adreima
12.2007 - 04.2015
Medical Biller and Coder
Lung Associates P.A.
08.2003 - 04.2024
Medicare Set-a-side Advisor
Gould&lamb, LLC.
08.2003 - 04.2007
Associates - Science - Health Administration
Keiser University
Medical Coding And Billing
Manatee Technical College