Marquetta Lucas
Elevance Health
Virginia Beach,VA
15
years of professional experience
Detail-oriented data and claims specialist with 10+ years of experience supporting healthcare operations provider reimbursement claims analysis and process improvement; managed complex data analysis to ensure claim accuracy, resolved escalations, and supported cross-functional teams; validated data using SQL, delivered reporting, and optimized workflows.
Work History
Senior Provider Reimbursement Specialist (Remote)
11 Years 10 Months- Verify provider claim submissions for accuracy and compliance, ensuring timely payment processing.
- Conduct peer reviews to maintain department quality standards and reduce errors.
- Research and analyze data to determine appropriate routing for financial payment workflows.
- Resolve high-priority business escalations within strict departmental deadlines.
- Collaborate with internal teams to improve claim adjudication processes and reduce rework.
Medical Claims Adjuster (Temp)
8 Months- Reviewed and adjusted complex medical claims for accuracy and policy compliance.
- Communicated with clients to verify data and obtain required documentation.
- Ensured claims met state-specific processing and regulatory requirements.
Patient Access Technician (Temp)
6 Months- Prepared admitting and discharge documents for adolescent patients.
- Verified procedure data and submitted information to appropriate hospital departments.
- Supported daily patient intake workflows to ensure efficiency and accuracy.
Education
Bachelor of Arts - Business Management
Associate of Arts
Skills
SQL
Facets
Macess
Microsoft Excel
Reporting & Documentation
Data Analysis
Process Improvement
Complex Problem Solving
Claims Processing & Healthcare Operations
Personal Information
Title: Business Management | Data Analyst Specialist
Timeline
Senior Provider Reimbursement Specialist (Remote)
Elevance Health
12.2014 - CurrentRead More
Medical Claims Adjuster (Temp)
Amerigroup, Norfolk, VA
03.2013 - 11.2013Read More
Patient Access Technician (Temp)
Children’s Hospital of The King’s Daughters
02.2012 - 08.2012Read More
Strayer University
Bachelor of Arts from Business Management
Read More
Fortis
Associate of Arts
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