Linda Manning
Drexel Hill,PA
Summary
Accomplished healthcare and insurance claims specialist with more than 25 years of progressive experience in claims adjustment, medical billing, and payment reconciliation. Expertise in analyzing complex claims, collaborating with insurance carriers to resolve discrepancies, and ensuring compliance with industry regulations. Demonstrated ability to streamline processes, enhance accuracy, and support organizational revenue goals. Highly skilled in managing high-volume workloads in both corporate and remote environments with a consistent record of performance excellence.
Overview
37
37
years of professional experience
1987
1987
years of post-secondary education
Work History
Claims Adjustment Specialist
UnitedHealthcare
Drexel Hill, PA
03.2022 - 08.2025
- Processed and adjusted complex medical claims with high accuracy.
- Collaborated with team members to resolve complex claims issues effectively.
- Analyzed trends in claim submissions to identify potential areas for improvement.
- Maintained detailed records of all claims adjustments and client interactions diligently.
- Investigated potentially fraudulent claims with focus on thoroughness, quality, and cost control.
- Interpreted policy language to determine coverage applicability to specific cases.
- Analyzed claim data and documentation to ensure accuracy of information.
- Ensured compliance with healthcare policies and regulatory guidelines.
- Provided support to providers and members by resolving claim discrepancies.
Receipts Specialist
Genesis Healthcare System
Kennett Square, PA
02.2018 - 10.2021
- Participated in ongoing training and compliance activities.
- Coordinated with other departments to ensure efficient workflow processes.
- Reviewed documents for accuracy prior to submission or publication.
- Maintained positive working relationship with fellow staff and management.
- Identified needs of customers promptly and efficiently.
- Utilized document management system to organize company files, keeping up-to-date and easily accessible data.
- Managed incoming payments and reconciled accounts.
- Researched discrepancies and ensured proper allocation of funds.
- Assisted in reducing outstanding accounts receivable through proactive follow-up.
- Communicated directly with insurance carriers (by phone, email, or portal).
- Followed up on claims to check payment status.
- Resolved payment issues, like denials, underpayments, or delays.
- Submitted appeals or corrected claims for reprocessing.
- Ensured timely reimbursement for services rendered.
AR Follow-Up Representative
Crozer-Keystone Health System
Chester, PA
09.2017 - 11.2017
- Followed up on unpaid insurance claims to secure reimbursement.
- Communicated with insurance carriers to resolve denials and underpayments.
- Maintained patient records and ensured accurate data entry in electronic systems.
- Collaborated with team members to improve workflow efficiency in daily operations.
- Assisted co-workers during busy periods or whenever needed in order to provide excellent customer service.
- Displayed strong telephone etiquette, effectively handling difficult calls.
- Consistently met daily performance goals set by management team members.
- Demonstrated strong problem solving skills when faced with challenging situations or complex inquiries from customers.
- Participated in training sessions designed to improve overall job performance.
- Collaborated with colleagues in other departments to ensure that all customer needs were met effectively.
- Performed administrative tasks such as filing documents and updating records.
Medical Billing Specialist
Community Health Systems, CHS
Chester, PA
09.2014 - 03.2017
- Process medical claims using established billing systems and protocols.
- Review patient accounts for accuracy and completeness before submission.
- Communicate with insurance providers regarding claim status and resolutions.
- Submitted and tracked medical claims to insurance companies.
- Resolved denied claims through appeals and documentation.
- Resolve billing discrepancies through research and effective problem-solving techniques.
- Adhered to HIPAA regulations when handling confidential patient information.
- Completed appeals and filed and submitted claims.
- Maintained detailed records of all billing activities including denials, adjustments, and payments received.
- Analyzed rejected claims and corrected errors as necessary before resubmitting them for payment.
- Submitted appeals for denied claims when appropriate according to the insurance company's criteria.
- Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
- Monitored aging accounts receivable balances ensuring timely resolution of outstanding balances.
- Initiated collection efforts on unpaid accounts by contacting insurance companies or patients directly via phone or mail.
Claims Payment Adjuster
Independence Blue Cross
Philadelphia, PA
11.1999 - 01.2014
- Evaluated claims to determine coverage under policy guidelines.
- Participated in training sessions related to new policies or procedures.
- Reviewed and adjusted healthcare claims for accuracy and compliance.
- Worked with providers and internal departments to resolve claim issues.
- Consistently exceeded performance benchmarks for accuracy and timeliness.
- Maintained accurate records of all claims activities in company management systems.
- Provided training and other assistance for new hires.
- Determined covered medical insurance for both facility and professional providers.
- Resolved medical claims adjustments by approving or denying documentation, calculating benefit due, initiating payment, or explaining denial.
Claims Service Representative
Reliance Insurance Company
King of Prussia, PA
10.1988 - 02.1999
- Provided customer service to policyholders regarding claims status.
- Supported claims team with data entry, filing, and reporting.
- Secured coverage for incoming claims.
- Performed telephone investigation with the insured, claimants, witnesses, and other related parties to obtain facts of the loss.
- Responsible for phoning in all appraisals to the appropriate appraisal company.
- Investigate, evaluate, negotiate, and settle collision claims.
- Review appraisal bills for accuracy of payments, month-ending reports.
- Served as back-up to the receptionist providing courteous and professional service to callers.
Education
West Philadelphia High School
Philadelphia, PASome College (No Degree) - Psychology
Lincoln University
Lincoln , PASkills
- Medical claims processing & adjustments
- Insurance billing & denials management
- Compliance & regulatory knowledge (HIPAA)
- Remote work proficiency
- Microsoft Office Suite & claims software
Timeline
Claims Adjustment Specialist
UnitedHealthcare
03.2022 - 08.2025
Receipts Specialist
Genesis Healthcare System
02.2018 - 10.2021
AR Follow-Up Representative
Crozer-Keystone Health System
09.2017 - 11.2017
Medical Billing Specialist
Community Health Systems, CHS
09.2014 - 03.2017
Claims Payment Adjuster
Independence Blue Cross
11.1999 - 01.2014
Claims Service Representative
Reliance Insurance Company
10.1988 - 02.1999
West Philadelphia High School
Some College (No Degree) - Psychology
Lincoln University