Martilyn Koster

Sr Claims Technician

HCSC -Blue Cross Blue Shield of NM

Albuquerque, New Mexico

11.2004 - 08.2020

Supported efficient handling of complex claims and followed up on open, denied, or suspended claims to complete required line items.
Examined claims, records and procedures to grant approval of coverage.
Researched claim inquiries from providers and members in order to resolve discrepancies.
Assigned appropriate codes to claims based on diagnosis, procedure, and services provided.
Processed claims for payment or forwarded to appropriate personnel for further investigation
Reviewed and processed incoming claims for accuracy and completeness.
Collaborated with fellow team members to manage large volume of claims.
Analyzed claim trends in order to identify areas of improvement in the processing system.
Advised customers on how best to submit a claim so that it is processed quickly and efficiently.
Retained strong medical terminology understanding in effort to better comprehend procedures.
Checked documentation for appropriate coding, catching errors and making revisions.
Performed data entry tasks related to processing of claims information into internal systems.
Processed appeals for denied claims within established time frames.
Interpreted complex medical terminology in order to accurately process requests for reimbursement.
Recognized by management for providing exceptional customer service.
Provided support and guidance to colleagues to maintain a collaborative work environment.
Collaborated closely with team members to achieve project objectives and meet deadlines.
Managed time effectively to ensure tasks were completed on schedule and deadlines were met.

Similar Profiles

Tyrena CrossTyrena Cross

Senior Program Management Coordinator at Health Care Service Corporation (HCSC/BCBSIL, NM, OK, TX, MT)Senior Program Management Coordinator at Health Care Service Corporation (HCSC/BCBSIL, NM, OK, TX, MT)