Summary
Overview
Work History
Education
Skills
Timeline
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Kemyetta Moore

Ruskin,FL

Summary

Highly reliable, organized, and trained Claims Specialist with a proven track record of 15+ years in successful claims management. Skilled in appeals, authorizations, and claims adjudication. Meticulous, resilient, and flexible in addressing diverse issues. Committed to maintaining professional relationships with clients to drive business results and increase profitability.

Overview

10
10
years of professional experience

Work History

Business Analyst-Remote

Cognizant Technology Solutions, CTS
06.2016 - Current
  • Claim Processor SME
  • Manage overall quality and productivity
  • Manage team in a fast paced SLA driven environment
  • Claim processing Medical/Hospital HMO, EPO/PPO, Medicare/Medicaid and CHIP Claims
  • Pay/Deny medical claims
  • Responsible for responding to member/provider appeal grievance correspondence by mail/email
  • Effectively resolve insurance and other billing issues
  • Responsible for appeals and authorizations

Claim Specialist

Amerigroup Corporation
06.2014 - 06.2016
  • provide expertise or general claims support by reviewing, researching , investigating processing and adjusting claims.
  • Analyze trends
  • meet established productivity and standard .


Education

High School Diploma -

Bowers/Whitley Adult & Community Center
Tampa, FL

Skills

  • Computer proficient
  • Administrative support
  • Data analysis
  • Adjustments
  • Time management skills
  • Analyze and identify trends
  • CPT/HCPCS coding
  • people leadership
  • Policy renewals
  • strategic planning
  • complex equipment
  • Health Insurance knowledge
  • Data driven
  • commercial claims processing
  • Medicaid/Medicare knowledge

Timeline

Business Analyst-Remote

Cognizant Technology Solutions, CTS
06.2016 - Current

Claim Specialist

Amerigroup Corporation
06.2014 - 06.2016

High School Diploma -

Bowers/Whitley Adult & Community Center

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Kemyetta Moore