Kathryne Mosley
Las Vegas,NV
Summary
I am passionate about further developing my claims skills and contributing to a dynamic team that is continuously growing and evolving. Seeking opportunities to apply knowledge I have gained over the last 11 months in claims handling and make a meaningful impact within the unit.
Overview
13
13
years of professional experience
Work History
Claims Technician (MMU)
Helmsman Management Services
08.2024 - Current
- Reviewed documentation for accuracy and completeness, reducing processing errors significantly.
- Analyzed claim trends to identify potential areas for process improvement.
- Provided exceptional customer support, addressing inquiries and resolving concerns promptly.
- Investigated claims for accuracy, verifying proper documentation to prevent fraud.
- Collaborated with team members to improve communication, resulting in a more productive work environment.
- Managed high volume of daily claims while maintaining attention to detail and superior customer service standards.
- Reduced claim processing time by streamlining workflow and implementing efficient procedures.
Surgical Coordinator
Retina Consultants of Nevada
12.2017 - Current
- Administrative tasks related to scheduling, pre-authorizing, and billing for surgeries for Retinal specialists at local ambulatory surgical centers and hospitals. Scheduled anesthesia block times with various companies and anesthesiologists. Scheduled diagnostic testing when medically needed for different types of anesthesia. Verified benefits for surgical copayments. Coordinated procedures specific to each physician, paying attention to details specific to each patient as well based on diagnosis. Handling time sensitive diagnoses and assisting patients with care. Coordinated the scheduling of surgical procedures accurately, recognizing the importance and relationship to patient care. Experienced with medical terminology, ICD-10 and CPT codes. Obtained referrals and pre-authorizations, verified patient demographics and insurance information.
Wellness Coordinator
The Joint Chiropractic
01.2016 - 01.2017
- Receive, sort and distribute daily mail/deliveries. Maintain security by following procedures and controlling access (monitor logbook, issue visitor badges) Update appointment calendars and schedule meetings/appointments. Perform other clerical receptionist duties such as filing, photocopying, transcribing and faxing. Selling and upselling patient's on packages for chiropractic services.
Sales Lead/Key Holder
Sur La Table
01.2012 - 01.2016
- As a floor leader some of these responsibilities included directing employees to ensure customer service standards were met and help resolve customer services issues in a timely manner, finding the most optimal solution whether that was in person or via the phone. I have demonstrated the ability to help and resolve issues and complaints (such as scheduling cooking classes, taking personal information, or ordering via FedEx or our distribution center). Whether it is a customer buying a small item or hosting a group of sixteen people who were participating in a private event within our cooking school classroom and professional grade kitchen, everybody is always treated equally as important and validated. Here I have demonstrated excellent verbal and written communication skills with employees as well as customers. Here we were required to take ownership, be responsible, and provide solutions within our stores. Making the right call and effectively blending my knowledge of products, customer service skills, and experience within the company has ultimately lead me to my current position. Sales are a very important part of my job here, being trained endlessly on products ranging from household appliances to smaller cookware. Effectively, I have year after year had the highest grossing sales in our electrics department for two years.
Education
High School Diploma -
Cimarron Memorial High School
Las Vegas, NV06.2010
Skills
- Jurisdictional formwork (NV & CA)
- Liability determination
- Investigation techniques
- Workers compensation
- Teamwork
- Time management
- Multitasking Abilities
- Organizing and prioritizing work
- Medical Terminology
- Adaptability and flexibility
- HIPAA
- Prior authorization processing
- Claims Technician
Timeline
Claims Technician (MMU)
Helmsman Management Services
08.2024 - Current
Surgical Coordinator
Retina Consultants of Nevada
12.2017 - Current
Wellness Coordinator
The Joint Chiropractic
01.2016 - 01.2017
Sales Lead/Key Holder
Sur La Table
01.2012 - 01.2016
High School Diploma -
Cimarron Memorial High School
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