Lawanda Young Walker
Birmingham,AL
Summary
Results-driven professional with extensive experience at Blue Cross Blue Shield of Alabama, excelling in claims evaluation and provider relations. Proven ability to leverage medical terminology and effective communication skills to resolve complex claims efficiently. Recognized for meticulous attention to detail and strong problem-solving capabilities, enhancing operational effectiveness and customer satisfaction.
Overview
29
29
years of professional experience
Work History
Senior Consolidator
Naphcare, Inc
Birmingham, AL
05.2015 - Current
- Review claims received for submission to claims processing.
- Review authorizations and medical records in order to identify services rendered and expected claims.
- Utilized advanced knowledge of medical terminology while reviewing claims.
- Develop and maintain provider billing contacts to pursue claims for all authorizations.
- Received statements and ensured that authorizations have been loaded to match the corresponding statements.
- Demonstrated the ability to prioritize, meet deadlines, and multitask while promoting efficiency and effectiveness within the daily workload.
- Demonstrate a strong attention to detail, and a commitment to customer service throughout the claim retrieval and review process.
Case Examiner
Blue Cross Blue Shield of Alabama
Birmingham, AL
03.2000 - 05.2015
- In this position, I worked with many areas within the company, gathering information needed in order to pay claims properly.
- Paying attention to detail allowed me to become familiar with contract benefits, as well as corporate specifications, which enabled me to settle any unpaid claims.
- I also gained valuable interpersonal skills, communication skills, and knowledge of processing different contract groups according to designated guidelines.
Coder Keyer
Blue Cross Blue Shield of Alabama
Birmingham, AL
06.1998 - 05.2000
- Entered coded data into electronic health record (EHR) systems.
- Entered patient insurance, demographic and health information into software and confirmed records.
- Recognize claims that were set based on special guidelines, which enabled me to determine which claims were to be routed to the appropriate department.
- I also assisted with backlogged work in other areas when needed, as well as made independent decisions necessary to perform my job in a timely manner.
Data Entry Lead
Control Data
Birmingham, AL
02.1996 - 06.1998
- Processed customer payments quickly and returned exact change and receipts.
- Inventoried stock and placed new orders to maintain supplies for expected demand.
- Counted and balanced cashier drawers.
- Balanced daily financial transactions using appropriate methods according to established procedures.
- Processed customer transactions accurately and efficiently.
- Issued receipts, refunds, credits or change due to customers.
- Assisted with pricing merchandise for sale in store.
Education
Associate of Science - Computer Science
Herzing Institute
Birmingham, AL05-1987
Skills
- Claims Evaluation
- Medical terminology
- Data analysis
- Electronic Health Record Oversight
- Provider relations
- Regulatory compliance
- detailed documentation
- Multitasking Abilities
- Time management
- Problem solving
- Effective communication
Affiliations
- Volunteer at blood drive held at church.
- assisted in different functions with kids
- An avid member of a roller skate group and help teach kids how to skate
Timeline
Senior Consolidator
Naphcare, Inc
05.2015 - Current
Case Examiner
Blue Cross Blue Shield of Alabama
03.2000 - 05.2015
Coder Keyer
Blue Cross Blue Shield of Alabama
06.1998 - 05.2000
Data Entry Lead
Control Data
02.1996 - 06.1998
Associate of Science - Computer Science
Herzing Institute