Latisha Henderson

• Review medical records to ensure accuracy of required information needed for pre-authorization requests.
• Maintain database of referral information and track referrals received and sent out.
• Developed a working knowledge of insurance plans, including Medicare and Medicaid regulations and requirements.
• Screen incoming requests for referrals, verifying accuracy of information and eligibility requirements.
• Performed daily audits of submitted claims to ensure compliance with industry standards and regulations.
• Participated in regular meetings to discuss referral strategies, network expansion, and program performance metrics.
• Maintained accurate records of all referrals, including contact information and follow-up activities.

• Verify insurance and gather essential data elements for accurate patient identification and billing.
• Register patients utilizing correct data entry protocols and adhering to comprehensive ICD-10 and CPT coding standards.
• Effectively liaised with patients, doctors, and staff members, evaluat medical charts, and foster a high level of communication and interaction.
• Update reference materials include Medicare, Medicaid, and third-party payer requirements, guidelines, policies, and a list of accepted insurance plans..
• Secure the required signatures for adherence to privacy laws and consent for treatment.

• Supervised, coordinated, directed and monitored staff activities to ensure prompt, courteous and accurate response to customers.
• Monitored and analyzed the proficiency and quality efforts of agents.
• Oversaw a team of over twenty agents, handling case management for reimbursements and class action lawsuits.
• Adhered to corporate confidentiality guidelines and federal regulations in protecting patient data.
• Streamlined operational efficiencies by accurately conducting new hire interviews and assisting management with employment decisions.
• Reported payroll utilizing people soft and administered employee benefits.
• Ensured operations through effective planning, leading, controlling and organizing.
• Recommended and implemented new and improved systems which enhanced productivity.
• Ensured that employees achieved adherence, maintained attendance, upheld conduct standards, and met performance objectives.
• Administered and adhered to Corporate and Departmental policies, practices and procedures.
• Conducted interviews, selected, trained, developed, and counseled agents.

Customer Service Claims Specialist

• Maintained comprehensive database for enrollment data, claim submission and payment information.
• Maintained knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes.
• Investigated and analyzed requirements to improve timeliness of reports to customers.
• Processed claims in compliance with established quality and production standards, making necessary corrections and adjustments to address issues.

• Managed guest check-in and check-out procedures, reservations and payments.
• Handled payment processing and provided customers with receipts and proper bills and change.
• Attended and monitored events to direct staff, proactively address issues and solve problems or concerns.
• Enforced staff performance and service standards to deliver consistent and positive customer experiences.
• Sought out and implemented methods to improve service and team performance to boost business sustainability.
• Adhered to strict operation and maintenance regulations by following instructions and observing guidelines.