Krystal Leonard

• Validated that all necessary documentation was included with each claim submission.
• Gathered and documented evidence to support court proceedings.
• Verified insurance coverage and eligibility of patients for services rendered.
• Checked into questionable claims, interviewing agents and claimants to resolve errors and omissions.
• Researched medical records to identify additional information needed for processing claims.
• Reviewed policies to determine appropriate levels of coverage and assist with approval or denial decisions.
• Sent clinical request and missing information letters to obtain incomplete information.
• Input claim information and payments into company database.
• Reviewed claims for accuracy before submitting for billing.
• Conduct a high volume of outbound calls, and send out or respond to electronic, written, and verbal inquiries to and from attorneys and insurance companies.
• Negotiation experience, specifically in the capacity of persuading and influencing others, and the ability to negotiate fair settlements consistent with the prevailing subrogation law.
• Drafted statement of loss to summarize damages, payments and underlying policy coverage.
• Reviewed police reports, medical treatment records, medical bills and physical property damage to determine extent of liability.
• Interacted with providers regarding claim status or other related issues as required.
• Ensured HIPAA compliance by maintaining strict confidentiality of patient information.

Knowledge of local, state, and federal laws and regulations pertaining to insurance.