Leon Harris
Solon
Summary
Dynamic Medical Claims Adjuster with a proven track record at Progressive, excelling in insurance claims processing and HIPAA compliance. Recognized for enhancing claim efficiency through innovative workflows and effective problem-solving. Strong communicator and team player, dedicated to continuous learning and delivering exceptional service in high-pressure environments.
Overview
8
8
years of professional experience
Work History
Medical Claims Adjuster
Progressive
Mayfield Heights, OH
04.2023 - Current
- Evaluated and processed medical claims for accuracy and compliance with policy guidelines.
- Collaborated with healthcare providers to obtain necessary documentation for claim resolution.
- Analyzed complex claims disputes, providing solutions that adhered to company standards.
- Conducted thorough reviews of claims to identify potential fraud or discrepancies.
- Developed streamlined workflows that improved claim turnaround time and efficiency.
- Analyzed policy details along with supporting documents provided by healthcare providers to make informed decisions on claims approvals or denials.
- Maintained strict compliance with HIPAA regulations, safeguarding patient privacy throughout the claim evaluation process.
Customer Service Representative
Progressive
Mayfield Heights, OH
04.2018 - 04.2023
- Provided exceptional support to customers via phone, email, and chat channels.
- Resolved customer inquiries and complaints efficiently, ensuring satisfaction.
- Maintained accurate records of customer interactions in CRM systems.
- Collaborated with team members to improve service delivery processes.
- Addressed product-related questions, guiding customers towards effective solutions.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Responded to customer requests for products, services, and company information.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Assisted customers in navigating company website and placing online orders, improving overall user experience.
Education
No Degree - Business Marketing
The Ohio State University
Columbus, Ohio, OHEducation
Cleveland Heights High
Cleveland Heights, OH06.1997
Skills
- HIPAA compliance awareness
- Organizational growth
- Effective communication
- Teamwork orientation
- Continuous learning mindset
- ICD-10 coding
- Problem solving prowess
- Data entry efficiency
- CPT coding
- Customer service
- Insurance claims processing
- HIPAA
- Teamwork
- Problem-solving
Timeline
Medical Claims Adjuster
Progressive
04.2023 - Current
Customer Service Representative
Progressive
04.2018 - 04.2023
No Degree - Business Marketing
The Ohio State University
Education
Cleveland Heights High