Summary
Overview
Work History
Education
Skills
Timeline
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Lisa Hills

Gladwin,MI

Summary

Results-driven professional effective in implementing positive change while overseeing multiple tasks. A team player with great time management and organizational skills. Pursuing a Claims Analyst position with an established company.

Overview

24
24
years of professional experience

Work History

EDI Technical Claims Analyst

BeneSys Inc.
Troy, MI
02.1999 - 06.2023
  • Evaluated pending claims to identify and resolve problems blocking auto-adjudication.
  • Precisely calculated refunds, premiums and adjustments.
  • Assisted claimants, providers and clients with problems or questions regarding claims.
  • Reviewed administrative guidelines whenever questions arose during processing of claims.
  • Based payment or denials of medical claims upon well-established criteria for claims processing.
  • Reviewed patient medical records for accuracy and completeness of claims information.
  • Provided customer service support by responding to inquiries from members, providers, employers, and insurance carriers.
  • Processed manual adjustments including voids, write-offs, refunds.
  • Stayed current on HIPAA regulations, benefits claims processing, medical terminology and other procedures.
  • Documented file notes clearly and concisely in multiple claim systems.

Education

Some College (No Degree) - Dental Assisting

Oakland Community College
Highland Lake Campus, Michigan

Skills

  • Claims Review
  • Claims Processing
  • Claims Evaluation
  • Claims Investigation
  • Document Workflow
  • Decision-Making
  • Coaching and Mentoring

Timeline

EDI Technical Claims Analyst

BeneSys Inc.
02.1999 - 06.2023

Some College (No Degree) - Dental Assisting

Oakland Community College

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Lisa Hills