Kristina Nersesova
Columbus
Summary
Results-driven Insurance Claims Manager with proven success in claims analysis, customer service, and conflict resolution. Adept at negotiating settlements and training new staff to enhance team performance. Extreme focus on accuracy and follow-up.
Overview
7
7
years of professional experience
Work History
Insurance Claims Manager
Stoner Periodontic and Implant Specialist
Dublin, OH
11.2022 - Current
- Managed claims processing, ensuring compliance with insurance regulations and company policies.
- Reviewed and adjudicated complex claims, improving accuracy and reducing errors in documentation.
- Trained new staff on claims management software and best practices for effective claim handling.
- Complied with established internal controls and policies.
- Maintained compliance with industry regulations during all stages of the claims process.
- Gathered sensitive information to update customer profiles and help with appeals process.
- Exceeded clients' expectations by compassionately gathering required medical and work history information to complete [Type] applications.
- Championed insurance claims process by providing expert knowledge and building positive, trusting relationship to support clients during challenging times.
- Negotiated settlements with claimants, achieving fair outcomes while controlling costs.
- Documented and communicated timely claims information while supporting accurate outcomes.
Insurance Specialist
Columbus Oral and Maxillofacial Surgery
Dublin, OH
10.2021 - 10.2022
- Managed patient insurance claims processing, ensuring accurate submissions and timely follow-ups.
- Collaborated with medical staff to gather necessary documentation for insurance approvals.
- Verified insurance coverage details, informing patients of their financial responsibilities prior to procedures.
- Analyzed claims data to identify trends and recommend process improvements for efficiency.
- Enhanced customer satisfaction by addressing insurance-related inquiries and resolving issues promptly.
- Processed eligibility and benefits verification and authorization requests.
- Followed up on denials, late payments, extensions and other special circumstances.
- Tracked pending authorizations to resolve discrepancies and avoid revenue loss.
Insurance Coordinator
Ohio Dental Clinic
Columbus, ND
06.2019 - 10.2020
- Coordinated patient insurance verification processes to ensure accurate billing and coverage compliance.
- Managed claims submissions and resolved discrepancies to expedite reimbursements for services rendered.
- Developed and maintained relationships with insurance providers to enhance communication and streamline workflows.
- Trained new staff on insurance protocols, improving team efficiency and accuracy in claim processing.
- Verified insurance and communicated coverage to staff and patients.
- Filed and tracked insurance claims and communicated claims status to patients.
- Prepared insurance claims for submission to clearinghouses or insurance companies.
- Enhanced customer satisfaction by efficiently handling insurance claims and processing policy updates.
Education
Bachelor of Science - Medical Billing And Coding
Remington College
Cleveland, OH05.2010
Bachelor of Science - Finance, Marketing And Management
University of Armenia
Yerevan, Armenia05.1991
Skills
- Claims analysis
- Policy interpretation
- Claims investigation and research
- Procedure implementation
- Teamwork and collaboration
- Customer service
- Decision-making
- Prioritizing and planning
- Conflict resolution
Timeline
Insurance Claims Manager
Stoner Periodontic and Implant Specialist
11.2022 - Current
Insurance Specialist
Columbus Oral and Maxillofacial Surgery
10.2021 - 10.2022
Insurance Coordinator
Ohio Dental Clinic
06.2019 - 10.2020
Bachelor of Science - Medical Billing And Coding
Remington College
Bachelor of Science - Finance, Marketing And Management
University of Armenia