Nicole Glass
Albion,IN
Summary
Proven Medical Claims Analyst at PHP of Northern Indiana, adept in HIPAA compliance and claims processing proficiency. Excelled in enhancing claim efficiency through automation, leading training initiatives, and fostering teamwork. Demonstrated reliability and attention to detail by streamlining adjudication processes and resolving complex issues, significantly improving operational workflows. Professional with strong background in medical claims analysis, adept at ensuring accurate and timely processing of healthcare claims. Skilled in data management, compliance, and problem-solving, with keen eye for detail. Focused on team collaboration and achieving results, adaptable to changing needs, and reliable in high-pressure environments. Strong analytical skills and thorough understanding of healthcare regulations and insurance policies.
Overview
17
17
years of professional experience
Work History
Medical Claims Analyst
PHP of Northern Indiana
09.2007 - Current
- Developed training materials for new hires to facilitate onboarding and skill development of Medical Claims Analysts.
- Demonstrated a commitment to continuous improvement by actively seeking out opportunities for process optimization within the Medical Claims Analyst role.
- Enhanced claim processing efficiency by implementing automated workflows and streamlining procedures.
- Conducted comprehensive audits to identify inconsistencies and irregularities in medical claims data.
- Managed high-volume caseloads for optimal productivity while maintaining strict attention to detail.
- Assisted in the development of standardized processes for claim adjudication across multiple insurance products.
- Researched and resolved complex medical claims issues to support timely processing.
- Paid or denied medical claims based upon established claims processing criteria.
- Coordinated with contracting department to resolve payer issues.
Education
High School Diploma -
Northrop High School
Fort Wayne, IN06.1990
Skills
Claims Processing Proficiency
HIPAA Compliance Understanding
Medical Terminology Familiarity
Training and mentoring
Medical terms and procedure knowledge
Proficiency in QNXT
Teamwork and Collaboration
Attention to Detail
Reliability
Claims Processing
Microsoft Office
Collaborative relationships
Timeline
Medical Claims Analyst
PHP of Northern Indiana
09.2007 - Current
High School Diploma -
Northrop High School
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