Keila Sanchez
Emmaus,PA
Summary
Insurance professional with comprehensive experience in claims management, adept at assessing, processing, and resolving claims efficiently with expertise in workers' compensation claims.
Bringing strong computer proficiency, organized and a dependable candidate successful at managing multiple priorities with a positive attitude. Looking to expand my knowledge in the insurance industry, primarily workers compensation with successfully completing a designation Workers Compensation professional (WCP) course.
Overview
9
9
years of professional experience
Work History
Insurance Follow Up Worker Compensation
Lehigh Valley Health Network
Pennsylvania
07.2021 - Current
- Work on several work queues to follow up on denial, payments, and credit claims.
- Working with claim adjusters within different carriers to confirm accepted injury in order to bill
- Working with legal teams on litigation claims
- Determining if claims are being paid correctly, using the workers comp fee schedule
- Determining which dates of service should be billed under worker comp coverage
- Familiar with doing fee reviews with the worker comp bureau WCAIS
- Training new employees on the job processes and procedures.
Referral Coordinator Specialist
Allergy & ENT Associates
Houston, Texas
03.2021 - 06.2021
- Receiving doctor referrals to schedule patients to see an allergist
- Scheduling appointments between 15 locations
- Scheduled patients, notifying of appointment date, time, and location.
- Managed incoming calls regarding referrals in a professional manner while providing accurate information.
Medical Receptionist/Team Trainer
Star Wellness Family Center (St Luke's Network)
01.2017 - 11.2020
- Scheduling for twenty-three Physicians
- Answering Calls
- Handling Medical Records
- Mail sorting
- Payment Collection of copays
- Insurance Verifications
- Referrals
- Training New Hires and Check in/check out Duties
Education
WORKER COMP CLAIMS -
AMERICAN SOCIETY OF WORKERS COMPENSATION CERTIFICATE
11.2025
Associate EHR - Electronic Health Records
Mccann School of Business And Technology
Allentown, PA12.2016
Skills
- Customer service
- Problem-solving
- Attention to detail
- Multitasking Abilities
- Organization and time management
- Decision-making
- HIPAA
- Medical billing
- Provider relations
- Claim denials management
Timeline
Insurance Follow Up Worker Compensation
Lehigh Valley Health Network
07.2021 - Current
Referral Coordinator Specialist
Allergy & ENT Associates
03.2021 - 06.2021
Medical Receptionist/Team Trainer
Star Wellness Family Center (St Luke's Network)
01.2017 - 11.2020
WORKER COMP CLAIMS -
AMERICAN SOCIETY OF WORKERS COMPENSATION CERTIFICATE
Associate EHR - Electronic Health Records
Mccann School of Business And Technology