Summary
Overview
Work History
Education
Skills
Timeline
Generic

Madia Mua

Fort Worth,Texas

Summary

Detail-oriented Claims Examiner with proven skills in claims processing, investigative analysis, and healthcare procedures. Committed to enhancing accuracy and efficiency in claims evaluation.

Overview

20
20
years of professional experience

Work History

Claims Examiner

Catalyst Health
Plano, TX
08.2023 - 05.2026
  • Evaluated and processed claims efficiently, ensuring compliance with company policies and regulations.
  • Analyzed claim documentation to determine eligibility and appropriate benefit levels based on guidelines.
  • Researched claims and incident information to deliver solutions and resolve problems.
  • Collaborated with medical professionals to clarify discrepancies in claim submissions and enhance accuracy.
  • Utilized claims management software to track case progress and update records systematically.

Senior Claim Processing Specialist

NETIMA
Euless, TX
03.2006 - 08.2023
  • Analyzed claim data to identify trends, informing strategic decisions for policy adjustments and training needs.
  • Followed up with customers on unresolved issues.
  • Tracked and reported on claims processing metrics to aid senior management in making informed decisions.
  • Posted payments to accounts and maintained records.

Education

High School Diploma -

East Compus
Merced, Ca
06-1990

Skills

  • Claims processing
  • Investigative skills
  • Healthcare procedures
  • Claims evaluation
  • Claims
  • Claims investigation
  • Benefits review
  • Teamwork

Timeline

Claims Examiner

Catalyst Health
08.2023 - 05.2026

Senior Claim Processing Specialist

NETIMA
03.2006 - 08.2023

High School Diploma -

East Compus