Mary Kinchen
Hammond,LA
Summary
Dedicated Data Claim Specialist professional with history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
7
7
years of professional experience
Work History
Claims Analyst
TTEC Services
Englewood, CO
07.2020 - Current
- Conducted thorough financial investigations to identify and classify damages for customer claims.
- Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
- Collected and tracked evidence in support of legal processes.
- Maintained strict confidentiality with all personal data as per company guidelines.
- Maintained claims data in WADWORTH/ CCMS, VROLL & VISA PAS systems.
- Documented information gathered and uploaded data to company database for efficient processing using WADWORTH & VISA PAS
- Collected evidence to support contested claims in court.
- Followed up on 6-10 potentially fraudulent claims initiated by claims representatives.
Direct Social Worker
All American Healthcare
Slidell, Louisiana
01.2015 - 03.2020
- Completed detailed charts to summarize interactions with patients and booked follow-up sessions.
- Offered therapeutic services and crises intervention to emotionally disturbed children and adolescents.
- Maintained regular contact with clients by calling and visiting clients' homes.
- Encouraged socialization and engagement through therapy, music therapy & social activities.
- Developed Functional Behavioral Assessment and Positive Behavioral Intervention Plan to identify the cause of problem behavior, formulate strategies to address behavior and teach new behavioral skills.
- Maintained record of daily individual activities, behaviors & pertinent incidents for patient analysis and assessment.
- Administered assessments and developed academic goals based on specific disabilities and barriers to learning.
- Visited and assisted 2- 3 patient's a day.
Education
Louisiana Board Certified - Phlebotomy
2004
High School Diploma -
02.1994
Skills
- Claims review
- Dispute tracking
- Skilled in LexisNexis, Wadworth, Visa Pas, VROLL,Orcit, Nice, Video Investigator, Microsoft Word, PowerPoint
- Document workflow
- Legal proceedings
- Familiar with fraud statutes
- Risk management
- Settlement determinations
- Documentation review
- Documentation abilities
- Data integrity
- Reporting skills
- Excellent Communication
Timeline
Claims Analyst - TTEC Services
07.2020 - Current
Direct Social Worker - All American Healthcare
01.2015 - 03.2020
Healthcare Training Institute - Kenner - Louisiana Board Certified , Phlebotomy
Live Oak High School - High School Diploma,
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