Masako Williams
Summary
Offering 6 years of experience and willingness to take on any challenge. Confident Insurance Advisor possessing strong work ethic and excellent business sense. Bringing 6 -year background customizing insurance plans, calculating premiums and interviewing potential clients to obtain data about financial resources. Excellent communicator and dependable team player with strong understanding of insurance industry. Adept at building relationships with clients, brokers and other stakeholders while delivering outstanding service. Highly organized and detail-oriented with strong ability to identify potential risks and develop solutions.
Overview
8
8
years of professional experience
Work History
Insurance Specialist 11
Abbvie Endocrinology
08.2023 - Current
- Enhanced customer satisfaction by addressing insurance-related inquiries and resolving issues promptly.
- Streamlined policy management by regularly updating client information and tracking policy changes.
- Reduced claims processing time by effectively collaborating with adjusters, claimants, and internal departments.
- Strengthened client relationships through consistent follow-ups, ensuring timely renewals and retention.
- Followed up on denials, late payments, extensions and other special circumstances.
- Acted as subject matter expert, answering internal and external questions and inquiries.
- Monitored changes in insurance industry to stay compliant with relevant laws and regulations.
- Improved operational efficiency by developing procedures for processing claims, payments, and endorsements.
- Ensured regulatory compliance through diligent monitoring of company practices and adherence to guidelines.
- Simplified complex insurance concepts for clients, facilitating informed decision-making regarding policy options.
- Processed eligibility and benefits verification and authorization requests.
- Resolved discrepancies in insurance payments by collaborating with carriers.
- Educated clients on insurance policies and procedures.
Benefit Verification Specialist
Acclara Solutions
08.2022 - 07.2023
- Improved patient satisfaction by accurately verifying benefits and providing timely responses to inquiries.
- Enhanced workflow efficiency by implementing a streamlined benefit verification process for the team.
- Reduced claim denials with thorough insurance eligibility assessments prior to service provision.
- Expedited claim approvals by promptly submitting necessary documentation to insurance providers.
- Maintained up-to-date knowledge of insurance regulations, enabling accurate benefit verifications for various plans.
- Provided exceptional customer service by addressing patient concerns regarding coverage and out-of-pocket expenses.
- Supported the revenue cycle through diligent follow-ups on pending claims and unresolved issues.
- Ensured compliance with HIPAA regulations during all aspects of the benefit verification process, protecting patient privacy.
- Facilitated smooth transitions for patients between care providers by coordinating authorizations for outpatient services.
- Leveraged advanced problem-solving skills in navigating complex cases involving multiple policies or payers, ultimately securing coverage approvals where possible.
- Analyzed and evaluated existing compensation and benefits programs and recommended improvements.
- Increased accuracy in data entry through meticulous attention to detail when inputting patient demographics and insurance information into the system.
Patient Access Representative 11
Wellstar Cobb Hospital
06.2018 - 05.2022
- Streamlined patient registration processes by implementing efficient data collection methods and reducing wait times.
- Maintained accurate patient records, contributing to a well-organized database for seamless information access across departments.
- Facilitated smooth billing processes by verifying insurance eligibility, obtaining authorizations, and accurately entering claim details into the system.
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
- Compiled and maintained patient medical records to keep information complete and up-to-date.
- Organized patient records and database to facilitate information storage and retrieval.
Authorization Specialist
Northside Hospital Cherokee
01.2016 - 03.2018
- Improved patient satisfaction by streamlining authorization processes and ensuring timely responses to inquiries.
- Enhanced departmental efficiency with thorough knowledge of insurance guidelines and medical terminology.
- Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests.
- Reduced processing times by effectively managing a high volume of authorizations, referrals, and appeals.
- Expedited claim processing by submitting complete and accurate information in accordance with payer requirements.
- Ensured prompt resolution of denied claims through comprehensive analysis of denial reasons and timely submission of necessary documentation for reconsideration or appeal.
- Evaluated trends in authorization denials to identify areas for improvement in both internal processes and external communications with payers.
- Facilitated smooth transitions between different levels of care by coordinating required authorizations for patients moving from one service setting to another.
- Conducted regular audits of authorization records to verify accuracy and adherence to regulatory requirements, minimizing risk of noncompliance.
- Assisted clients with accurate eligibility form, application and document completion.
- Resolved discrepancies with client applications to verify eligibility.
- Facilitated information and resource exchanges with external agencies to progress client applications.
Education
High School Diploma -
Community Christian College
GA01.2005
CERTIFIED NURSING ASSISTANT -
Trident Technical College
Charleston, SC05.2002
Associate of Science - Medical Assisting
Westwood College - O'Hare Airport
Chicago, IL06.1999
Skills
- Reporting Abilities
- Documentation Abilities
- Documentation Skills
- Customer Service
- Insurance Law Knowledge
- Professionalism
- Time Management
- Problem Solving
- Claims Management
- Organizational Skills
- Claims Reporting Systems
- Health Insurance
Timeline
Insurance Specialist 11
Abbvie Endocrinology
08.2023 - Current
Benefit Verification Specialist
Acclara Solutions
08.2022 - 07.2023
Patient Access Representative 11
Wellstar Cobb Hospital
06.2018 - 05.2022
Authorization Specialist
Northside Hospital Cherokee
01.2016 - 03.2018
High School Diploma -
Community Christian College
CERTIFIED NURSING ASSISTANT -
Trident Technical College
Associate of Science - Medical Assisting
Westwood College - O'Hare Airport
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