Kinyanna Brooks
Mesquite,TX
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, and effective communication skills, Adept at working unsupervised and quickly mastering new skills. Dedicated and adaptable professional with a proactive attitude and the ability to learn quickly. Eager to contribute to a dynamic team and support organizational goals.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Claims Trainee
Magnit
Dallas, TX
01.2021 - Current
- Researches and analyzes claim documentation thoroughly to determine pertinent details.
- Prepares well written communication to all clients, internal and external, and conveys simple to moderately complex information to all appropriate parties while maintaining a professional demeanor in all situations.
- Makes claim processing determinations based on knowledge, training, and experience and processes claims according to policy provisions and state regulations.
- Ensures that claim handling is conducted in compliance with applicable statues, regulations, and other legal requirements, and that all applicable company procedures and policies are followed.
- Maintains detailed files including all claim documents and correspondence.
- Interacts with customer service representatives, legal counsel, and other various departments to aid in claim handling.
- Performs other duties as assigned.
- Maintains familiarity with policies and procedures, as well as the business and organization. Complies with company and regulatory guidelines.
Claims Representative/ Preauthorization
UT Southwestern Hospital
Dallas, Texas
12.2016 - 01.2021
- Summarizes documents and enters into claim system notes
- Negotiates and settles claims in accordance with business unit best practices
- Documents a claim file with notes, evaluations, and decision-making process
- Works in electronic claim files to handle assigned claims within designated authority. Manage diaries, update claim files and move them to closure according to established procedures and job aids provided for training purposes.
- Handles contents inventories and basic and occasionally moderately complex pricing analysis and prepares claims reports
- Reviews, evaluates, and submits potential underwriting referral actions
- Communicate with insurance companies; Obtain referrals, authorization, pre-determinations
- Data entry of information on approvals/denials into our electronic medical system and or Billing system
Education
Associate of Applied Science -
Clarendon College
Clarendon, TX05-2003
Skills
- Strong organization skills
- Data Collection and Analytical Skills
- Excellent Customer Service Skills
- Investigational skills
- Multi Call handling
- Attention to Detail
- Problem-Solving
- Professionalism
Certification
All Lines Accredited Claims Adjuster License Texas 4/2024
Timeline
Claims Trainee
Magnit
01.2021 - Current
Claims Representative/ Preauthorization
UT Southwestern Hospital
12.2016 - 01.2021
Associate of Applied Science -
Clarendon College
All Lines Accredited Claims Adjuster License Texas 4/2024
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