Latonya Huff
Magellan Health
Williamston,NC
8
years of professional experience
Detail-oriented Claims Specialist with expertise in ICD-10 and CPT coding, medical claims processing, and Coordination of Benefits guidelines. Demonstrated ability to adjudicate claims accurately, resolve denials, and ensure compliance with CMS regulations. Skilled in utilizing IPProd claims processing systems to identify and rectify discrepancies while ensuring timely claim resolution.
Work History
Claims Representative
4 Years 2 Months- Analyzed claim documentation to determine eligibility and validate coverage details for accurate processing.
- Collaborated with internal teams to resolve discrepancies and improve claims workflow efficiency.
- Calculated adjustments, premiums and refunds.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Maintained confidentiality of patient finances, records, and health statuses.
- Checked documentation for accuracy and validity on updated systems.
- Worked productively in a fast-moving work environment to process large volumes of claims.
Customer Service Representative
4 Years 1 Month- Maintained detailed records of customer interactions, contributing to a a comprehensive database for future reference.
- Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
- Increased first-call resolution rates by carefully listening to customers'' needs and providing accurate information based on their inquiries.
- Expanded knowledge in medical terminology and insurance policies through continuous learning initiatives, enhancing accuracy in communication with clients.
- Delivered exceptional support during high call volume periods by maintaining composure and professionalism under pressure.
- Resolved complex billing issues, enhancing patient satisfaction through effective communication.
Education
Associate of Science - Human Services
Skills
Microsoft Office
Claims processing
Data entry
Multitasking skills
Professional conduct
Time management
Claim denial analysis
Timeline
Claims Representative
Magellan Health
05.2022 - 07.2026Read More
Customer Service Representative
Florida Blue
01.2018 - 02.2022Read More
Pitt Community College
Associate of Science from Human Services
Read More