Summary
Overview
Work History
Education
Skills
Timeline
Generic

Michaela Daniels

Columbus

Summary

Detail-oriented and highly organized professional with experience in claims processing, medical billing, and coding. Adept at analyzing claims, applying medical necessity guidelines, and ensuring accurate adjudication. Skilled in handling claim discrepancies, eligibility verification, and cost-containment measures. Strong ability to work in fast-paced production environments while maintaining quality and efficiency.

Overview

Work History

Medical Billing Specialist

Change Healthcare
  • Processed insurance claims, verifying accuracy and coding compliance
  • Worked closely with providers and insurance companies to resolve billing discrepancies
  • Applied ICD-10, CPT, and HCPCS coding to ensure proper reimbursement
  • Ensured HIPAA compliance in all documentation and patient interactions

Claims Processor

UnitedHealth Group
  • Reviewed and adjudicated claims according to policy guidelines and medical necessity standards
  • Utilized claims processing systems to verify member eligibility, coverage, and coding accuracy
  • Communicated with providers to clarify claim details and ensure proper reimbursement
  • Maintained a strong understanding of Medicaid and private insurance claim processes

Customer Service Representative

Maximus
  • Processed Medicaid and Medicare claims while ensuring compliance with government guidelines
  • Assisted members and providers with eligibility verification and claim inquiries
  • Resolved claim discrepancies and escalated complex cases as needed
  • Maintained productivity and quality metrics in a high-volume call center environment

Education

Medical Billing & Coding - In Progress

American Academy of Professional Coders (AAPC)
05-2025

Associate of Science - Computer And Information Sciences

Cincinnati State Technical And Community College
Cincinnati, OH
05-2020

Skills

  • Claims Processing & Adjudication
  • Medical Billing & Coding
  • Medicaid & Insurance Verification
  • Data Entry & Accuracy
  • Problem-Solving & Attention to Detail
  • Customer & Provider Communication
  • HIPAA Compliance
  • Quality-oriented team player
  • Insurance verification

Timeline

Medical Billing Specialist

Change Healthcare

Claims Processor

UnitedHealth Group

Customer Service Representative

Maximus

Medical Billing & Coding - In Progress

American Academy of Professional Coders (AAPC)

Associate of Science - Computer And Information Sciences

Cincinnati State Technical And Community College
Michaela Daniels