LAQUISHA PATTERSON
Covington,GA
Summary
Health Information Specialist with over 11 years of extensive expertise in healthcare administration, Analytical Claims Specialist with proven experience investigating and resolving property, health and business claims. Delivers professional and balanced customer service and meets needs of insured, claimant and internal and external customers. Insurance expert with exceptional knowledge of legal liabilities and claims practices and superior interpersonal skills.
Overview
11
11
years of professional experience
Work History
Health Information Specialist II
Piedmont Hospital
01.2016 - Current
- Maintained electronic and paper-based patients' files and other healthcare records in a manner consistent with medical, administrative, and legal regulations
- Processed admission and discharge records in an accurate and timely manner as well as filed lab or X-ray test reports, slips and other related information into patients' charts
- Scanned new discharge charts into electronic medical record system as well as maintained completed medical records
- Gathered and managed patients' demographic and related information from various sources as well as assembled medical records of new patients
Senior Claim Benefit Specialist
CVS Pharmacy
Atlanta, GA
12.2019 - 01.2026
- Documents claim information in the company system, assigning appropriate codes, modifiers, and other necessary data elements to ensure accurate tracking, reporting, and processing of claims.
- Conducts reviews and investigations of claims that require additional scrutiny or validation to ensure proper claim resolution.
- Communicates with healthcare providers, patients, or other stakeholders to resolve any discrepancies or issues related to claims.
- Conducted audits on claims procedures, ensuring adherence to regulatory requirements and best practices.
- Evaluated and settled complex insurance claims in strict timeframes.
Claims Specialist (Remote)
State Farm
REMOTE
02.2020 - 01.2025
- Handled all assigned claims promptly and effectively
- Ensure Claims Are Managed To The Correct Payment Duration
- Determined proper policy coverages and applied appropriate claims practices to reach case resolution
- Escalated all claims to necessary departments and reviewed all claims documents for accuracy
- Acted as liaison in reference to all severe incident reports, reinsurance reports and all other case needs
- Built long lasting client relationships and prioritized outstanding customer service
Education
High School Diploma -
Hertiage High
Conyers, GA05-2010
Skills
- Data Entry
- Verbal and Written Communication
- Claim Amount Calculations
- Medical Insurance
- Eligibility Determination
- Coverage Determination
- Microsoft office
- Data Analysis
- Epic/ EHR
- CPC
- Management Skills
- Healthcare IT systems
- HIPAA compliance
- Medical billing
- Data privacy practices
Timeline
Claims Specialist (Remote)
State Farm
02.2020 - 01.2025
Senior Claim Benefit Specialist
CVS Pharmacy
12.2019 - 01.2026
Health Information Specialist II
Piedmont Hospital
01.2016 - Current
High School Diploma -
Hertiage High
EDUCATION AND TRAINING
- EMR
- ROI
- Business Technolgy
- AHIMA
- HIPAA