Summary
Overview
Work History
Education
Skills
Timeline
Generic

Lucretia Coulter

Fort Scott,KS

Summary

Accomplished Sr. Claims Examiner with a proven track record at Mphasis, adept in claims processing and coverage evaluation. Excelled in multitasking and time management, consistently surpassing performance metrics. Skilled in Multiple Claims Systems and possesses strong organizational abilities. Renowned for transforming client relationships through effective communication and meticulous data verification.

Overview

13
13
years of professional experience

Work History

Sr. Claims Examiner

Mphasis
03.2021 - Current
  • Process claims for multiple clients ensuring accuracy per contract and exceeding turn around time.
  • Complete pend reports and weekly check runs for each client.
  • Communicate with Clients, Customer Service Representatives, and Management to achieve personal and professional goals.
  • Manually price and process claims that are not system adjudicated.
  • Exceeding performance metrics consistently while maintaining quality standards and PHI security.
  • Training coworkers when transferring them new clients


Claims Examiner

Tabula Rosa Systems
07.2019 - 03.2021
  • Claims processing ensuring accuracy of claim information and pricing based on each contract.
  • Completing inventory, pended claims and adjustments within a timely manner.
  • Communicating with clients directly to review and update contracts and processing rules.

Data Entry/Claims Examiner

Cobalt Medplans
12.2011 - 07.2019
  • Handled sensitive information with discretion, ensuring confidentiality of personal and financial details.
  • Data Entry of medical claims along with processing of said claims.
  • Reduced claim processing time by implementing efficient workflow strategies and prioritizing tasks effectively.
  • Meeting and exceeding company goals on productivity and quality.

Education

Bachelor of Science - Business Management

Pittsburg State University
Pittsburg, KS
08-2008

Skills

  • Claims processing
  • Coverage evaluation
  • Time management
  • Multitasking
  • Computer skills: Excel, MS Office, PCM, Facets, BEN, Microsoft Teams, JIRA, Pacelogic, Outlook, SharePoint, etc
  • Organizational skills
  • Verbal communication
  • Data verification
  • Investigative skills

Timeline

Sr. Claims Examiner

Mphasis
03.2021 - Current

Claims Examiner

Tabula Rosa Systems
07.2019 - 03.2021

Data Entry/Claims Examiner

Cobalt Medplans
12.2011 - 07.2019

Bachelor of Science - Business Management

Pittsburg State University
Lucretia Coulter