LAURA DAVIS
Redmond
Summary
As a Senior Claims Analyst for more than 22 years and 32 years in the industry, I have taken on a wide range of responsibilities. I strive for accuracy in everything I do and will take on whatever is asked of me with focus and determination. Maintaining good relationships with my peers, being flexible, and working with a team to accomplish goals have all contributed to my continued personal growth and success as a claims analyst.
Overview
32
32
years of professional experience
Work History
Claims Analyst III
HWMG
Honolulu
07.2024 - Current
- Reviewing and processing UB's with individual contracts
- Manually applying correct pricing, benefit codes and edits to flagged claims
SENIOR CLAIMS ANALYST
Shasta Administrative Services
Bend
09.1994 - 06.2024
- Review and processing of high dollar claims
- Reviewing and applying possible edits
- Reprocessing or Adjustments of previously processed claims
- New Client Implementation
- Audited examiners to maintain quality control and adherence to standards
- Application of Medicare Like Rates across multiple systems
- Accumulator review and adjustment
- Manual prescription processing
- Customer Service
- Testing of new processes
- Working Remotely while maintaining 99.95% procedural accuracy and 99.96% financial accuracy
Education
PROGRAM-CERTIFICATION ACHIEVED - MEDICAL RECORDS AND TRANSCRIPTION
Central Oregon Community College
Bend, OR06-1994
Skills
- Review and comparison of large documents with document summaries for consistency
- Determining whether an edit should apply related to the plan document as well as the intentions of the plan
- Experience working with Tribal clients and customized plans
- Working remotely while exceeding accuracy standards
- Detail Oriented
- Long time Customer Service experience
- Working with a team to accomplish goals for an organization
- High personal standard of work
Timeline
Claims Analyst III
HWMG
07.2024 - Current
SENIOR CLAIMS ANALYST
Shasta Administrative Services
09.1994 - 06.2024
PROGRAM-CERTIFICATION ACHIEVED - MEDICAL RECORDS AND TRANSCRIPTION
Central Oregon Community College