Makali Strong
CHARLOTTE,NC
Summary
Detail-oriented Claims Management Specialist with a proven track record of maintaining 99% coding accuracy while processing over 350 claims daily. Expertise in ICD-10-CM, CPT, and denial resolution ensures optimal reimbursement outcomes.
Overview
5
5
years of professional experience
Work History
Claims Management Specialist
Experity
Remote, US
10.2025 - 07.2026
- Reviewed and processed up to 350+ professional claims, denials, payments, and billing accounts daily, consistently exceeding established productivity expectations.
- Validated ICD-10-CM, CPT, HCPCS Level II, E/M levels, modifiers, charges, and supporting documentation for outpatient and professional services.
- Maintained up to 99% coding accuracy while applying official coding guidelines, payer requirements, National Coverage Determinations, and Local Coverage Determinations.
- Reviewed operative reports, office procedures, injections, surgical services, hospital consultations, rounds, admissions, and other clinical documentation for code and charge accuracy.
- Reviewed recurring coding and billing errors, documented corrective actions, and maintained a reported 97% quality score.
- Completed payment posting, corrected-claim preparation, payer follow-up, medical-necessity research, and account documentation across Medicare, Medicaid, BCBS, Cigna, Aetna, UnitedHealthcare, and other commercial payers.
- Used Experity, Waystar, Availity, Codify, Encoder, Microsoft Excel, and multiple payer portals to manage high-volume remote workflows with minimal supervision.
Healthcare Tech
Atrium Health
Concord, NC
06.2022 - 02.2023
- Reviewed up to 250+ patient records and billing accounts daily for ICD-10-CM, CPT, HCPCS, E/M, modifier, charge, and documentation accuracy.
- Achieved a documented 98% coding accuracy rate and 98% quality score while supporting hospital and professional billing workflows in Epic.
- Reviewed clinical records, provider documentation, failed claims, billing holds, DNFB accounts, UB-04 elements, and payer edits before account resolution.
- Researched coding-related denials, corrected claim errors, and supported appeals and follow-up activity that contributed to a 95% denial-overturn rate.
- Prioritized aging and time-sensitive accounts to support timely charging, claim submission, and reimbursement.
Certified Nursing Assistant
Hope Stone Home Care
Concord, NC
05.2021 - 01.2022
- Processed and reviewed approximately 150+ medical claims, care notes, home-visit records, and billing transactions daily.
- Validated ICD-10-CM, CPT, HCPCS Level II, modifiers, service dates, authorizations, and documentation for home-care, Medicaid, hospice, and podiatry-related services.
- Maintained approximately 98% accuracy while reviewing provider notes and visit documentation for completeness before claim submission.
- Performed insurance verification, claim submission, payment posting, payer research, account correction, denial follow-up, and reimbursement tracking.
- Helped achieve a documented 95% denial-overturn rate by researching rejected claims, correcting billing discrepancies, and supplying supporting documentation.
- Communicated documentation and billing concerns to providers and internal staff to reduce delays and support compliant reimbursement.
Education
Associate of Applied Science - Health Administration
Rowan-Cabarrus Community College
Salisbury, NC05-2028
Certified Professional Coder -
AAPC
06-2026
Skills
- Outpatient Professional-Fee Coding
- ICD-10-CM, CPT, HCPCS
- E/M Coding
- Modifier Review
- Operative Report Review
- Charge Review
- Official Coding Guidelines
- Medical Necessity Review
- NCD/LCD Validation
- Claims Editing
- Denial Resolution
- Payment Posting
- CMS-1500
- UB-04
- Medicare, Medicaid, BCBS, UHC and Commerical Payers
Timeline
Claims Management Specialist
Experity
10.2025 - 07.2026
Healthcare Tech
Atrium Health
06.2022 - 02.2023
Certified Nursing Assistant
Hope Stone Home Care
05.2021 - 01.2022
Associate of Applied Science - Health Administration
Rowan-Cabarrus Community College
Certified Professional Coder -
AAPC