Kayla French
Helena,MT
Summary
Claims Examiner with deep knowledge of medical, dental and vision claims industry. Solid abilities in developing objectives and strategies to settle difficult claims. Excellent skills compiling, coding, categorizing and auditing information to process claims.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Health Claims Examiner
Allegiance Benefit Plan Mgmt.
09.2021 - Current
- I am responsible for processing medical, dental and vision claims with precise accuracy
- I work with ICD-9, ICD-10 and CPT Codes all day every day
- I have made my way up to Claims Examiner Level 2
- I am a very hardworking and dedicated employee
- I am responsible for requesting refunds, submitting reversals and submitting history voids.
- I love being a Claims Examiner
Customer Service Representative
ALLEGIANCE BENEFIT PLAN MANAGEMENT
09.2018 - 03.2022
- I am responsible for answering phone calls and going over claims questions with members and providers, providing phenomenal customer service, answering prior authorization questions, explaining member benefits and exclusions, breaking down accumulators, working in Excel, PDF, Word and Outlook
- I also occasionally help out with indexing claims into the system and work as a team
- Familiar with using procedure codes and ICD-10 codes.
Store Specialist
Spectrum
12.2015 - 02.2018
- I am responsible for end of day paperwork and counting down tills
- I process customer payments and explain customer bills to them
- I provide phenomenal customer service to our customers and answer questions to the best of my ability
- I scan new equipment into the system and put it all away
- I am responsible for keeping a clean desk and keeping the lobby and cash room nice and tidy
- I setup customers with new services, put customers in new promotions, and work with a serviceability team to make address serviceable in the system.
Route Sales Representative
Schwans Home Food Service
03.2015 - 11.2015
- At Schwans I was responsible for driving truck in town and out of town to deliver quality food to existing customers, knocking on doors and asking people to sign up to become a customer, do end of day paperwork and cash handling, delivering deposit to the bank every night, and providing fantastic customer service.
Logistics Specialist
Office Depot OfficeMax
03.2013 - 11.2014
- At Office Depot I was responsible for receiving truck shipments and putting products away, completing end of shelf setup projects, doing inventory once a day, providing great customer service, helping out at the cash register when needed, helping out in Copy and Print when needed and helping complete customer projects.
Education
GED -
Helena High School
Helena, MT05.2012
Skills
- Customer Service
- Call Center
- CSR
- ICD-10
- CPT Coding
- ICD-9
- Medical Records
- EMR Systems
- Medical Billing
- Medical Coding
- Physiology Knowledge
- Customer service
- HIPAA
- Medical records
- Medical coding
- Medical terminology
- Cash handling
- ICD coding
- Cash register
- Policy Interpretation
- Verbal Communication
- Claims Processing
- Decision-Making
- Team Collaboration
- Claims Evaluation
- Benefits review
- Computer Literacy
- Claims
- Adaptability and Flexibility
- Attention to Detail
- Effective Communication
- Written Communication
- Excellent Communication
- Healthcare Common Procedures Coding System (HCPCS)
- Task Prioritization
- Reliability
Personal Information
Work Permit: Authorized to work in the US for any employer
Certification
PAHM- Professional, Academy for Healthcare Management
MHP- Managed Healthcare Professional
PHIAS- Professional, Health Insurance Advanced Studies
FHIAS- Fellow Health Insurance Advanced Studies
DIA- Disability Income Associate
HIA- Health Insurance Associate
HCSA- Healthcare Customer Service Associate
Timeline
Health Claims Examiner
Allegiance Benefit Plan Mgmt.
09.2021 - Current
Customer Service Representative
ALLEGIANCE BENEFIT PLAN MANAGEMENT
09.2018 - 03.2022
Store Specialist
Spectrum
12.2015 - 02.2018
Route Sales Representative
Schwans Home Food Service
03.2015 - 11.2015
Logistics Specialist
Office Depot OfficeMax
03.2013 - 11.2014
GED -
Helena High School
PAHM- Professional, Academy for Healthcare Management
MHP- Managed Healthcare Professional
PHIAS- Professional, Health Insurance Advanced Studies
FHIAS- Fellow Health Insurance Advanced Studies
DIA- Disability Income Associate
HIA- Health Insurance Associate
HCSA- Healthcare Customer Service Associate
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