Summary
Overview
Work History
Education
Skills
Timeline
Generic

Natasha LeDay

Cypress,TX

Summary

Results-driven professional with extensive experience in managing caseloads and optimizing insurance processes. 10+ years of experience in insurance claims management, insurance verification, customer service, and healthcare billing. Proven expertise in Medicaid and Medicare systems, complemented by strong communication skills. Achieved a 20% reduction in processing errors through meticulous documentation review, showcasing a commitment to accuracy and proactive problem-solving. Aiming to leverage these skills to further enhance operational efficiency in the healthcare sector.

Overview

5
5
years of professional experience

Work History

Care Management Support Coordinator II

TekSystems-Centene (Remote)
Hanover, MD
08.2024 - Current
  • Provided education about available community resources such as housing, employment opportunities, financial assistance programs.
  • Managed caseloads consisting of up to 20-25 individuals at any given time.
  • Completed assessments of client needs and preferences.
  • Handled sensitive information with discretion, maintaining confidentiality and compliance with relevant laws and policies.

Appointment Scheduler

Widescope-Optum Serve (Remote)
Powder Springs, GA
01.2024 - 07.2024
  • Setup Appointments/Follow Up with Physicians, Vision, Dental, Radiology, and other Various Providers & Hospitals for Veterans.
  • Followed HIPAA Regulations & Compliance.
  • Maintained composure and professionalism in high-pressure scenarios through active listening and empathetic communication, resulting in 30% increase in customer satisfaction scores.

Claims Specialist

SAGILITY HEALTH-(Remote)
Westmoore Circle, CO
02.2022 - 12.2023
  • Maintained knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes.
  • Implement rigorous double-check procedures for documentation of denied/accepted insurance claims by meticulously verifying each claim policy guidelines & medical records, resulting in 20% reduction in processing errors
  • Communicated with other departments to establish action plans and manage open claims to closure.

Insurance Verification Specialist

Clayton Services-The Smith Center
Houston, TX
11.2019 - 02.2022
  • Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
  • Communicated with insurance carrier, patient, and third party or employer to verify patient insurance benefits.
  • Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
  • Updated patient and insurance data and input changes into company computer system.

Education

Some College (No Degree) - : BACHELOR OF SCIENCE IN HEALTH ADMINISTRATION

University of Phoenix
Katy, TX

Skills

  • Documentation review
  • Settlement determinations
  • Coverage assessments
  • Medicaid & Medicare knowledge
  • Medical terminology
  • HIPAA Regulations & Compliance
  • Communication Skills
  • Commercial Insurance knowledge
  • Problem-Solving Skills
  • Attention to Detail
  • Meeting deadline

Timeline

Care Management Support Coordinator II

TekSystems-Centene (Remote)
08.2024 - Current

Appointment Scheduler

Widescope-Optum Serve (Remote)
01.2024 - 07.2024

Claims Specialist

SAGILITY HEALTH-(Remote)
02.2022 - 12.2023

Insurance Verification Specialist

Clayton Services-The Smith Center
11.2019 - 02.2022

Some College (No Degree) - : BACHELOR OF SCIENCE IN HEALTH ADMINISTRATION

University of Phoenix

Similar Profiles

CREATE PROFILE
Natasha LeDay