Mikki Manisa

• Managed insurance claims follow-up process to ensure timely resolution and payment.
• Reviewed patient accounts for accuracy and compliance with insurance policies.
• Collaborated with healthcare providers to obtain necessary documentation and support for claims.
• Implemented process improvements that enhanced claims tracking efficiency and accuracy.
• Facilitated timely follow-up on outstanding insurance claims to ensure prompt resolution.
• Analyzed denial reasons to implement corrective actions and improve reimbursement rates.
• Collaborated with cross-functional teams to streamline billing processes and enhance operational efficiency.
• Maintained comprehensive documentation of follow-up activities using electronic health record systems for compliance purposes.
• Implemented efficient workflows for claim submissions, reducing processing delays from insurers.
• Streamlined follow-up processes for improved efficiency, ensuring timely resolution of unpaid claims.
• Provided exceptional customer support to patients and insurance companies, fostering positive relationships and maintaining a high level of client satisfaction.
• Analyzed denial patterns regularly to develop targeted strategies for reducing claim rejections.
• Supported team members in resolving complex issues, fostering a collaborative work environment focused on continuous improvement.
• Collaborated with insurance companies to expedite claim processing, improving cash flow management.
• Monitored aged account receivables closely to identify trends affecting payment cycles.
• Negotiated payment arrangements with patients facing financial difficulties, enhancing customer loyalty and retention.
• Reduced denials and underpayments through effective communication with payers, leading to increased revenue.
• Participated in regular staff meetings to discuss and strategize action plans for problematic accounts, resulting in improved collections performance.
• Maintained thorough documentation of all follow-up activities, ensuring proper tracking and reporting of account status.
• Improved patient satisfaction by addressing their concerns related to insurance claims and explaining the process in layman''s terms.
• Enhanced claim resolution rates by diligently reviewing and analyzing outstanding insurance claims.
• Managed multiple priorities effectively while working within tight deadlines, ensuring optimal outcomes for both clients and the organization as a whole.
• Developed strong relationships with payer representatives, facilitating faster issue resolution for unpaid claims.
• Contributed to team success by meeting or exceeding monthly collection goals while maintaining high standards of accuracy and professionalism.
• Resolved patient disputes promptly regarding insurance coverage or billing matters.
• Investigated and resolved customer inquiries and complaints quickly.
• Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
• Responded to customer requests, offering excellent support and tailored recommendations to address needs.
• Delivered prompt service to prioritize customer needs.
• Exhibited high energy and professionalism when dealing with clients and staff.
• Met customer call guidelines for service levels, handle time and productivity.

• Responding to incoming calls from members and providers on issues related to benefits, eligibility, and claims questions

• Guide and educate members on their plan benefits

• Ask appropriate questions and listen actively while documenting required information in the computer systems

• Identify issues and communicate solutions to members and providers

• Make outbound calls to members and providers to assist with benefits, eligibility and claim status