Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline

Naomi Henderson

Conroe,TX

Summary

Seasoned Claims Benefits Specialist with 5 years of experience in the healthcare insurance sector, adept at analyzing, processing, and resolving insurance claims with a proven 98% accuracy rate. Proficient in medical billing and coding, committed to ensuring compliance with regulatory standards. Seeking to leverage expertise in claims processing and problem-solving in a healthcare role.

Overview

7
7
years of professional experience

Work History

Claims Benefits Specialist

CVS Health
06.2024 - Current
  • Process and resolve claims efficiently, ensuring compliance with regulations and reducing errors by 15%
  • Collaborate with team members to streamline workflows, enhancing overall productivity and client satisfaction
  • Analyze claim data to identify trends and implement solutions, resulting in measurable improvements
  • Communicate with clients to clarify claim details, fostering trust and ensuring accurate processing
  • Conduct thorough claim analyses to identify patterns, implementing data-driven solutions that lead to measurable improvements in processing efficiency
  • Foster teamwork to optimize workflows, boosting overall productivity and elevating client satisfaction through seamless claim resolution processes.

Claims Specialist

Highmark Health
06.2022 - 10.2023
  • Processed insurance claims with 98% accuracy, ensuring compliance with policies and regulatory standards
  • Evaluated claims by analyzing documentation and conducting interviews to determine eligibility and coverage
  • Communicated claim outcomes to stakeholders, collaborating with internal teams to resolve complex cases
  • Optimized claims adjudication process, leading to substantial cost savings and improved customer satisfaction
  • Consistently met and exceeded performance targets.

Medical Claims Processor

Molina Health
03.2020 - 06.2022
  • Processed medical claims ensuring compliance, accuracy, and adherence to regulatory standards
  • Reviewed claims for eligibility and necessity using medical coding and billing expertise
  • Resolved complex pre-authorization and appeal issues with analytical problem-solving
  • Communicated effectively with stakeholders, addressing inquiries promptly
  • Streamlined claims processing workflow, reducing turnaround time and enhancing accuracy in medical necessity evaluations and policy compliance
  • Optimized pre-authorization procedures, significantly decreasing appeals and improving stakeholder satisfaction through efficient issue resolution.

Client Services Representative

B&B Fashions
01.2018 - 01.2020
  • Resolved customer inquiries, ensuring satisfaction and fostering positive relationships
  • Provided detailed product information, aiding customers in styling, sizing, and material choices
  • Worked with warehouse staff to streamline order processing, boosting delivery efficiency
  • Optimized customer interactions, enhancing product knowledge and styling expertise to drive sales and foster long-term client relationships.

Education

Associate of Science - Medical Billing and Coding

Ultimate Medical Academy, Clearwater, FL
02.2021

High School Diploma -

University View Academy, Baton Rouge, LA
05.2018

Skills

  • Claims Review
  • Claims Processing Proficiency
  • Medical Billing Expertise
  • Insurance Verification
  • HIPAA Compliance
  • Analyzing Claims
  • Compliance Knowledge
  • Data Analysis
  • Adaptability
  • Time Management
  • Attention to Detail
  • Data Integrity
  • Quality Assurance
  • Medical Terminology
  • Release of Information
  • Revenue Cycle
  • Account Management
  • EOB
  • Claims Adjudication
  • Electronic Health Records (EHR) Proficiency

Accomplishments

  • Reduced the average turnaround time for processing information requests by 30%, ensuring timely and efficient service for clients and stakeholders.
  • Received recognition for exceptional customer service by achieving a 95% satisfaction rating in customer surveys through effective communication and resolution of claims issues.
  • Implemented a new double-check system that increased accuracy in claims handling, reducing errors by 15% and minimizing overpayments.
  • Successfully streamlined the claims processing workflow, reducing average processing time by 20%, resulting in faster settlements and improved customer satisfaction.

Timeline

Claims Benefits Specialist - CVS Health
06.2024 - Current
Claims Specialist - Highmark Health
06.2022 - 10.2023
Medical Claims Processor - Molina Health
03.2020 - 06.2022
Client Services Representative - B&B Fashions
01.2018 - 01.2020
Ultimate Medical Academy - Associate of Science, Medical Billing and Coding
University View Academy - High School Diploma,

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Naomi Henderson