Kristy Koehler
Waupun,WI
Summary
Detail-oriented Claims Representative with 13+ years of experience processing Medicare, Medicaid, and commercial claims. Recognized for exceptional accuracy, productivity, and handling complex claims.
Overview
13
13
years of professional experience
Work History
Claims Representative III / Plan-to-Plan Specialist
Elevance Health (Anthem)
04.2013 - 06.2026
- - Processed Medicare, Medicaid, commercial, behavioral health, LTSS, FQHC, RHC, ITS, and high-dollar claims.
- - Coordinated benefits, researched/priced claims, adjusted claims, reviewed authorizations, identified fraud, processed transplant cases, exceeded productivity and accuracy goals.
- Remote
Education
High School Diploma -
Waupun High School
Waupun, WISkills
- Medicare and Medicaid claims processing
- CMS guidelines compliance
- Coordination of benefits (COB)
- Medical terminology expertise
- Microsoft Word and Excel proficiency
- Customer service excellence
- Documentation review skills
- Typing speed of 95 WPM
- Attention to detail
- Time management
Timeline
Claims Representative III / Plan-to-Plan Specialist
Elevance Health (Anthem)
04.2013 - 06.2026
High School Diploma -
Waupun High School