Monaleah Bowen
CorVel-MTA Location
Brooklyn
1
Certification
19
years of professional experience
Experienced with thorough investigation and assessment of insurance claims. Utilizes critical thinking and detailed analysis to ensure fair and timely settlements. Track record of strong understanding of regulatory compliance and effective communication with stakeholders.
Work History
No Fault Claim Examiner
3 Years 3 Months- Evaluated complex claims for accuracy and adherence to Regulation 68 guidelines.
- Conducted thorough investigations to verify claim validity and mitigate fraud risks. Referring claims to SIU as needed
- Utilized analytical skills to evaluate medical bills for accuracy and appropriateness of charges before approving payments as part of the claims process.
- Enhanced customer satisfaction by promptly addressing inquiries and providing accurate information on claim status.
- Organized team meetings to address organizational challenges related to claims management and develop solutions collaboratively to ensure regulation 68 is being implemented correctly.
No Fault Medical Examiner
3 Years 8 Months- Reviews medical records and bills to verify claimed treatment are medically necessary and related to mva accident Follow up with
- Follow-up with I/P’s, Attorney and medical provider for treatment status
- Schedule IME appointments accordingly
- Resolve any coverage condition code
- Identify and recommend referral of potentially fraudulent claims to the Special Investigation Unit.
- Ensures adequacy of reserves and advance authority.
- Manages, evaluates and resolves claims assigned by Claims Team Manager and claims department
- Pay, deny or delay bills
Receptionist
2 Years- Answered phones and transfer calls to appropriate department
- Greeted and direct children with ASD to their scheduled therapist
- Schedule psychological evaluations and therapy sessions
- Prepare and type all psychological, speech, OT and ABA reports
- Assist parents with billing and diagnostic coding for insurance reimbursement
- Billing and coding
- Inventory ordering
Receptionist/Office Assistant
1 Year 7 Months- Provided comprehensive Administrative support to management and staff
- Scheduled Appointments and respond to all inquiries
- Greeted visitors and answered busy multi -line phone system; screened and directed calls to appropriate personnel as necessary
- Assisted clients with Tax preparation
- Managed office operations on a daily basis which included faxing, photo copying and filing documents accordingly
- Prepared memos for presentations
Home Health Aide/Personal Assistant
2 Years 3 Months- Assisted client with mental disabilities with activities for daily living to facilitate independence and confident
- Accompanied client to routine doctor’s visit
- Scheduled appointments and planned future events
- Provided dietary needs and assistant with patient hygiene
- Liaison with medical team to ensure safety and fall prevention
- Ensured client home was clean and well mannered
- Coordinated pick up and drop off services
Education
Associates Degree - Liberal Arts
Bachelor's in Science - Psychology
Skills
Basic knowledge of Microsoft Office
Outlook
Access
Excel
Atlas
Opig
Medflow
ISO
Word
45-50wpm
Capable of working under minimal supervision to initiate and complete duties as assigned
Strong decision making skills and able to multitask
Strong written and verbal communication skills
Great negotiation skills
Claims processing
Verbal communication
Accomplishments
- Supervised team of Six staff members.
- Reduced amount of bills out of compliance through effectively helping with claim management and bill processing.
Certification
- No-Fault Claim Examiner Training - Three months
Languages
English
Full Professional
Timeline
No Fault Claim Examiner
CorVel-MTA Location
03.2023 - CurrentRead More
No Fault Medical Examiner
Geico
03.2018 - 11.2021Read More
Receptionist
The McCarton Center For Developmental Pediatrics
01.2015 - 01.2017Read More
Receptionist/Office Assistant
New May Flower services
01.2010 - 08.2011Read More
Home Health Aide/Personal Assistant
Private Client
08.2007 - 11.2009Read More
Borough of Manhattan Community College
Associates Degree from Liberal Arts
Read More
Brooklyn College
Bachelor's in Science from Psychology
Read More