Kenisha Perry
Greensboro,NC
Summary
Diligent Claims Processor versed in insurance processes and claims procedures. Offers great attention to detail and time management abilities to successfully handle large volume of claims. Highly accurate and thorough with focus on completing error-free work in line with processing guidelines. Most of my experience is in the health insurance industry which I have been a part of in various ways for over 10 years. I am a self-driven, self-determined, think outside of the box individual, and I believe these attributes would make me a valuable addition to any company.
Overview
15
15
years of professional experience
Work History
Claims Processor II
Prime Therapeutics LLC
12.2023 - Current
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Managed workload and priorities to meet claims processing meet deadlines.
Claims Analyst
Highmark Blue Cross BlueShield of Western New York
09.2019 - 04.2024
- Resolve claim edits, review history records and determine benefit eligibility for service
- Review payment levels to arrive at final payment determination
- Determine if claim information is complete and correct
- Enter and verify claims data while ensuring accuracy and following standard operating procedures
- Process complex claims per UB04, 1500 and paper claim forms.
Member Service Representative
Highmark Blue Cross BlueShield of Western New York
09.2017 - 09.2019
- Assisted members with their benefits and claims questions
- Simplified and clearly communicated plan and claims processing which enabled the member to better understand their health plan
- Delivered a concierge level of service to members via phone, chat and in person by going above and beyond to ensure a first time resolution.
Customer Service Representative/Intake Coordinator
Meritain Health
12.2014 - 09.2017
- Assisted members and providers by phone and chat with health plan information as well as claims information
- Assisted providers with prior authorization intake and timely processing
- Utilized multiple systems to ensure information accuracy and timely filing and resolution of claims and prior authorizations.
Phlebotomist/Donor Screener
Upstate New York Transplant Services
09.2009 - 05.2015
- Documented donor information
- Performed basic vitals of donors (blood pressure, pulse, temperature, finger stick) to ensure the most successful donation
- Assembled collection containers for plasma and blood donation while following standard operating procedures
- Performed blood and plasma collection while being attentive to the donor to ensure a positive outcome and experience from beginning to end.
Education
Bachelor of Science in Individualized Studies -
University of New York College of Buffalo
Buffalo, NY01.2007
Skills
- Technical Proficiency: Facets, Pega, MS Excel, MS Word, MS Powerpoint, MS Outlook
- Excellent written and verbal communication skills
- Detail Oriented
- Able to work with others effectively and efficiently
- Strong ability to multitask
- Great organizational skills
- Effective analytical and problem solving skills
- Strong ability to think outside the box, visualize and create when needed
- Professionalism and Ethics
- Policy Interpretation
- Data entry proficiency
- Insurance Regulations Understanding
- Critical Thinking
- Claims Processing Software
Timeline
Claims Processor II
Prime Therapeutics LLC
12.2023 - Current
Claims Analyst
Highmark Blue Cross BlueShield of Western New York
09.2019 - 04.2024
Member Service Representative
Highmark Blue Cross BlueShield of Western New York
09.2017 - 09.2019
Customer Service Representative/Intake Coordinator
Meritain Health
12.2014 - 09.2017
Phlebotomist/Donor Screener
Upstate New York Transplant Services
09.2009 - 05.2015
Bachelor of Science in Individualized Studies -
University of New York College of Buffalo
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