Self-motivated, dependable, and an expeditious learner. Committed to fostering a collaborative work environment, and enhancing operational processes through effective teamwork and innovative problem-solving. Organized Administrative Assistant known for productivity and efficient task completion. Specialize in time management, data entry, and customer service skills. Excel at communication, problem-solving, and adaptability, ensuring smooth office operations and positive interactions.
Overview
8
8
years of professional experience
Work History
Claims Research Analyst
Alliance Health
Morrisville, North Carolina
06.2025 - Current
Analyzed medical claims for accuracy and compliance with company policies.
Identified trends in claim denials and recommended process improvements.
Reconciled account transactions utilizing various payment systems such as ERA'sand EOB’s.
Assisted in training new analysts on claims processing procedures.
Documented findings and maintained accurate records in the claims database.
Followed all company procedures to keep data confidential.
Reviewed denied claims, identified discrepancies and determined appropriate course of action.
Advised healthcare providers on filing requirements, documentation needed, and other matters pertaining to their denied claims.
Reviewed appeals filed by healthcare providers who were dissatisfied with initial decisions made concerning their cases.
Coordinated with healthcare providers to verify services rendered and resolve billing discrepancies.
Utilized claims processing software to update and maintain accurate claim files.
Analyzed claims data to determine coverage and liability, ensuring accurate decision-making.
Evaluated provider contracts for accuracy in accordance with payer regulations.
Provided customer service support by responding to inquiries from providers.
Researched and resolved billing discrepancies, coding issues, and other payment problems.
Collaborated with healthcare providers to resolve outstanding claims issues.
Investigated appeals from providers regarding denied or underpaid claims.
Managed workflow tasks according to established timelines and departmental standards.
Collaborated with fellow team members to manage large volume of claims.
Organized information by using spreadsheets, databases or word processing applications.
Administrative Assistant III (Claims)
Alliance Health Plan
Morrisville, US
12.2024 - 06.2025
The claims administrative assistant provides administrative support to the claims teams as well as completes specific claims related responsibilities.
Receive/screen/key and document paper claims from providers
Maintain departmental spreadsheets
Handles inquiries
Conducts research by using different Alliance systems
Handles inbound calls from providers
Advanced Production Operator
ABB
Mebane, US
04.2022 - 09.2024
As an advanced production operator in the electrification division you are responsible for wiring and building low voltage switchgear.
Our daily tasks are setting up, monitoring, and maintaining machines and equipment used in production lines.
We are responsible for operating machines, making repairs, replacing parts, and testing the finished product.
Accounting Administrator
Redeye Worldwide
Hillsborough, US
11.2019 - 04.2022
Reviewing and reconciling accounts, processing payments to external partners and maintaining updated records of invoices and receipts.
Perform customer service tasks (email invoices, credits, proof of delivery)
Set up New Customers
Process customer credits
Sort and Deliver Mail Daily
Scan checks into Bank using Check Scanner
Process All Credit Card Payments (Requests PayPal Payments)
Post and apply all payments received
Maintained Physical and Electronic filing systems
Mechanical Licensing (issue license agreements to labels)
Reached out to customers daily about payments
Order Picker
PHE
Hillsborough, US
10.2021 - 03.2022
Pick items needed for customer order in a timely manner.
Picker/Packer
Redeye
Hillsborough, US
03.2019 - 11.2019
Picking vinyl records, tapes, and cd's & packing orders.
Call Center Representative
Sports Endeavors
Hillsborough, US
06.2018 - 03.2019
Provide telephonic customer service regarding orders for multiple online stores.
Resolved issues in a timely manner, tracked/processed orders, actively listened to customers to ensure I'm providing the service asked.