Lynnette Williams

• Assisted customers with inquiries, providing timely and accurate information.
• Resolved customer complaints efficiently, ensuring satisfaction and retention.
• Managed order processing and fulfillment using company software systems.
• Collaborated with team members to enhance service delivery standards.
• Maintained knowledge of products and services to assist customers effectively.
• Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
• Addressed customer inquiries to ensure satisfaction and foster positive service experience.

Responsible for claim data entry involving the meticulous process of electronic health records and managing health-care related information for billing and reimbursement purpose. Review document, compute line items and totals for accuracy and completeness to ensure that all required fields are filled correctly to meet productive standards and quality assurance.

Reviewed and assessed insurance claims filed. Assisted in understanding and interpreting terms and conditions of insurance policies. Gathered information related to claims through medical record reviews and software research to propose settlement offers. Interacted with medical professionals to provide updates, address concerns, and negotiate settlements. Maintained accurate spreadsheets and detailed records of all communication and negotiation activities related to each claim. Supported end-of-month reporting to peers with claims negotiated and percentage of savings.

Achieved accuracy in reviewing worker's compensation medical bills from spreadsheets, ensuring compliance with fee schedule regulations. Enhanced data entry processes to confirm correctness and calculate line item totals efficiently. Optimized software usage for accurate coding and documentation of electronic health records. Drove productivity targets and quality assurance measures to prioritize urgent claims effectively. Delivered thorough audits of printed explanations of benefits prior to client release.

Achieved accurate reimbursement through meticulous auditing of routine and complex medical bills and analysis of electronic records for worker's compensation claims. Delivered expertise in medical terminology, billing codes, ICD diagnosis codes, and HCPCS for effective procedure coding. Maintained up-to-date knowledge of healthcare regulations and compliance standards from CMS for Medicare and Medicaid services and private insurers. Resolved issues promptly by computing totals and reviewing explanations of benefits. Consistently met production standards and quality assurance for reimbursement accuracy. Expanded responsibilities to include reviewing and auditing auto claims for Kemper Auto Insurance, utilizing the same skill set.