LaTonya Tingle

Compiled, sorted, and verified accuracy of demographic, financial, and customer data prior to entry, ensuring data integrity.

Accurately and effectively enter information into the system while maintaining accuracy of 99% and production rate of 10 claims per hour.

Compared data with source documents and utilized verification formats to detect and correct data entry errors, enhancing overall data quality.

• Resolved complex claim issues through detailed investigation and analysis.
• Evaluated claim submissions for accuracy and compliance with company policies.
• Processed rework claims by comparing benefits, checking internal resources, and applying corrections as needed.
• Documented claim findings and maintained accurate records for audits.

• Reviewed claims for accuracy & ensure proper processing guidelines have been applied.
• Adjusted claims as necessary when appropriate benefits have not been assigned.
• Determine medical necessity, coverage, eligibility, and identify discrepancies

• Ensured contracts were properly loaded and linked to provider tax identification numbers.
• Linked provider tax identification number and service locations to appropriate provider.
• Performed routine demographic maintenance on participating and nonparticipating providers.