Kimberly Kirk
Reynoldsburg,OHIO
Summary
Dynamic Medical Claims Adjustment Processor with a proven track record at United Healthcare, excelling in customer service and attention to detail. Enhanced departmental efficiency through process improvements and reduced claims backlog. Skilled in data entry and critical thinking, consistently achieving production targets while fostering teamwork and collaboration across departments.
Overview
26
26
years of professional experience
Work History
Medical Claims Adjustment Processor
United Healthcare
05.1999 - Current
- Evaluated current processes regularly, identifying areas of potential improvement to boost overall department efficiency levels.
- Stayed up-to-date on industry regulations and best practices, continuously enhancing knowledge base for improved job performance.
- Managed a high volume of claim inquiries from member/providers promptly addressing concerns/questions about the claim review process.
- Collaborated with other departments for smooth inter-departmental communication regarding complex claims issues.
- Maintained thorough documentation to support claim decisions, ensuring compliance with company policies and industry regulations.
- Enhanced provider/member satisfaction by providing timely and accurate claim resolutions.
- Examined claims forms, medical records and policies to determine insurance coverage.
- Enhanced team collaboration, sharing best practices for efficient processing techniques.
- Provided outstanding member/provider services by promptly addressing inquiries and resolving issues.
- Adhered to strict deadlines for processing claim inquiries, ensuring timely approvals and member/provider satisfaction.
- Demonstrated flexibility when adapting to new processes or guidelines while maintaining consistently high levels of productivity.
- Reduced errors with meticulous attention to detail and thorough review of documentation.
- Developed expertise in various processing systems for increased efficiency and accuracy.
- Collaborated with cross-functional teams to ensure smooth handoffs and timely completion of projects.
- Contributed to the achievement of department goals through consistent high-quality work.
- Utilized strong analytical skills to identify discrepancies within processed claims quickly.
- Mastered industry-specific software tools to expedite data entry tasks and reduce manual input errors.
- Maintained high levels of data security by adhering to strict data protection policies.
- Met production targets and tight deadlines by collaborating closely with team members.
Education
Accounting
Franklin University
Columbus, OHAccounting
Whitehall Yearling High School
Whitehall, Ohio06.1978
Skills
- Attention to detail
- Teamwork and collaboration
- Customer service
- Data entry experience
- Multitasking and organizing
- Critical thinking
Timeline
Medical Claims Adjustment Processor
United Healthcare
05.1999 - Current
Accounting
Franklin University
Accounting
Whitehall Yearling High School
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