Michelle Kasparie
Liberty,IL
Summary
Senior Claims Technician with Health Care Service Corporation, recognized for enhancing claim processing efficiency by streamlining workflows and implementing quality control measures. Skilled in claims investigation and effective communication, I excel in multitasking and fostering teamwork, driving improvements that significantly reduced processing times and elevated accuracy rates.
Overview
26
26
years of professional experience
Work History
Senior Claims Technician
Health Care Service Corporation
Quincy, Il
04.2000 - Current
- Coordinated with contracting department to resolve payer issues.
- Communicated effectively with staff members of operations, finance and clinical departments.
- Maintained confidentiality of patient finances, records, and health statuses.
- Calculated adjustments, and refunds.
- Processed and recorded new policies and claims.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Worked with multiple department to expedite processing in alignment with procedures.
- Assisted with training new employees, sharing knowledge and expertise to ensure smooth onboarding process.
- Implemented quality control measures to reduce errors in claim processing, increasing overall accuracy rates within the department.
- Improved departmental organization through the implementation of an effective filing system for claim documents.
- Maintained accurate records of all claims processed, ensuring compliance with company policies and industry regulations.
- Increased efficiency by automating routine tasks, enabling faster claim resolution times.
- Reduced claim processing time by streamlining workflow and implementing efficient procedures.
- Managed high volume of daily claims while maintaining attention to detail and superior customer service standards.
- Collaborated with team members to improve communication, resulting in a more productive work environment.
- Evaluated complex claims situations, providing expert guidance to support informed decision-making processes.
- Supported management in identifying trends and areas for improvement in claim resolutions.
- Implemented process improvements to enhance workflow efficiency within the department.
- Assisted in training new team members on claims processing protocols and systems.
- Conducted thorough reviews of claims documentation to ensure completeness and accuracy.
- Processed and evaluated claims for accuracy and compliance with policy guidelines.
- Worked in multiple departments and books of business including BlueCard.
Education
High School Diploma -
Camp Point Central
Camp Point, IL05.1992
Skills
- Claims processing
- Investigation techniques
- Claims investigation
- Teamwork and collaboration
- Problem-solving
- Time management
- Attention to detail
- Problem-solving abilities
- Multitasking Abilities
- Organizing and prioritizing work
- Excellent communication
- Critical thinking
- Active listening
- Effective communication
- Adaptability and flexibility
- Teamwork skills
- Team building
- Self motivation
Timeline
Senior Claims Technician
Health Care Service Corporation
04.2000 - Current
High School Diploma -
Camp Point Central