KORINNE THOMAS

• Analyze, and research complex Medicaid and Medicare healthcare claims to identify discrepancies, verify pricing, confirm prior authorizations, and process them for payment by navigating across various computer systems and programs to locate critical information.
• Responsible for accurate and timely processing of complex claims and/or adjustments to ensure all contractual obligations are met with the highest level of member/provider satisfaction.
• Review audits and respond to all error reporting within specified deadlines following departmental and corporate guidelines to ensure accuracy of claims processing and customer satisfaction.
• Worked productively in fast-moving work environment to process large volumes of claims.
• Examined reports, accounts, and evidence to determine integrity and accuracy of information.
• Maintained accurate and up-to-date records of claim information for future references.
• Researched and analyzed complex claims to determine next steps and possible outcomes.
• Processed and recorded new policies and claims.
• Maintained confidentiality of patient finances, records, and health statuses.
• Checked documentation for accuracy and validity on updated systems.
• Maintained strong knowledge of basic medical terminology to better understand services and procedures.

• Identified, analyzed, and interpreted trends or patterns in complex data sets by finding correlations and visualizing with charts.
• Completed data cleaning and data validation of existing spreadsheets to promote robust data management platform, resulting in accurate data analysis and entry.
• Utilized various professional statistical techniques and maintained large databases to collect and analyze data from partners and customers.
• Identified bugs in data collection or reporting and investigated root causes.
• Triaged and tracked internal and external data requests.
• Aggregated data from various sources to construct streamlined data pipelines.
• Shadowed interdepartmental personnel to better understand methods for handling daily tasks and job duties.
• Performed routine tasks under direct supervision and within established procedures and guidelines.
• Monitored and controlled data upload, checking for successful data import and quality.
• Attended workshops and seminars to remain current on computer applications.
• Analyzed user concerns, requirements and requests for system features and uses.
• Commissioned and decommissioned data sets under mentor supervision.
• Performed data investigations analysis as necessary.
• Deployed predictive analytics models to forecast future trends.
• Developed customized reports, summarizing and presenting data in visually appealing format.
• Utilized data visualization techniques to present and explain complex data sets.
• Analyzed data to identify root causes of problems and recommend corrective actions.

• Entered DCO-151 and DCO-152 Medicaid Application forms into the Curam and answer

Systems for the Department of Health and Human Services.

• Processed 151s and 152s Affordable Health Care Applications, Medicaid, and Medicare Health claims.

• Screened incoming calls, scan documents, directs calls, and transmitted messages.

• Prepared external and internal outgoing spreadsheets and follows established procedures and guideline requirements.

• Provided routine data entry, keying in information into designated fields using various databases.

• Organized, sorted, and checked input data against original documents.
• Completed data entry tasks with accuracy and efficiency.
• Entered numerical data into databases with speed and accuracy using 10-key pad.
• Scanned documents and saved in database to keep records of essential organizational information.
• Sorted documents and maintained organized filing process.
• Collated and organized data entry documents into filing systems for easy access.
• Followed established procedures to enter and process data correctly.
• Verified accuracy of data entered into system to produce error-free reports.
• Secured and protected data from unauthorized access by complying with security protocols.
• Entered data into various computer systems accurately using Microsoft Office Suite.
• Coded and processed applications into required electronic formats.
• Produced monthly reports with advanced Excel spreadsheet functions.
• Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
• Developed and updated spreadsheets and databases to track, analyze, and report on performance and sales data.
• Received and sorted incoming mail and packages to record, dispatch, or distribute to correct recipient.
• Volunteered to help with special projects of varying degrees of complexity.
• Created and maintained detailed administrative processes and procedures to drive efficiency and accuracy.

• Operating cash registers, providing customer service, and maintaining store appearance.
• Organized racks and shelves to maintain store visual appeal, engage customers, and promote specific merchandise.
• Answered customer questions about sizing, accessories, and merchandise care.
• Engaged with customers to effectively build rapport and lasting relationships.
• Accurately processed POS transactions, returning coin, currency, payment cards, and receipts to customers.
• Provided positive first impressions to welcome existing, new, and potential customers.
• Prepared merchandise for sales floor by pricing or tagging.
• Helped customers locate products and checked store system for merchandise at other sites.
• Educated clients on current promotional offerings and products using persuasive selling tactics.
• Managed returns, exchanges and refunds in accordance with store policy.

• Providing customer service, training new cashiers, and operating cash registers.
• Organized racks and shelves to maintain store visual appeal, engage customers, and promote specific merchandise.
• Answered customer questions about sizing, accessories, and merchandise care.
• Accurately processed POS transactions, returning coin, currency, payment cards, and receipts to customers.
• Provided positive first impressions to welcome existing, new, and potential customers.
• Prepared merchandise for sales floor by pricing or tagging.
• Helped customers locate products and checked store system for merchandise at other sites.
• Managed returns, exchanges and refunds in accordance with store policy.
• Answered customer questions about products and services, helped locate merchandise, and promoted key items.
• Volunteered for extra shifts during holidays and other busy periods to alleviate staffing shortages.
• Stocked merchandise, clearly labeling items, and arranging according to size or color.
• Managed efficient cash register operations.