Pasoua Yang
Kronenwetter,WI
Summary
Experienced claims processor skilled in various aspects of claim processing, including verifying authorization, identifying duplicate claims, adjusting corrected claims, pricing claims, and reviewing medical documentation. Actively collaborated with the knowledge team to enhance the clarity and usability of Olli, resulting in improved financial accuracy for claim processors. Subject Matter Expert (SME) providing one-on-one support to struggling processors by addressing their questions and reviewing edits to enhance their performance. Committed professional dedicated to exceptional customer service and achieving outstanding results. Efficiently addresses customer needs and resolves issues. Reliable team player with strong adaptability and effective communication skills. Proven track record in fostering collaborative environments and driving high levels of customer satisfaction.
Overview
22
22
years of professional experience
Work History
Claim Resultion Rep 1
WPS Health Solutions
02.2016 - 03.2025
- Review claim images with Facets
- Verifying and selecting procedure code and diagnosis codes using ICD-9, ICD-10, CPT, and HCPCS manuals
- Adjudicate specialty claims, including, but not limited to, pharmacy, ambulatory surgery, skilled nursing, anesthesia, medical assistance, reprocessed claims, duplicate claims, ambulance, durable medical equipment, or institutional based charges
- Verifying authorization in WM-Ware through Care Radius
- Reading and understanding Medical Documents
- SME for struggling processors who needed additional assistant
Customer Service Associate
West Corp
10.2015 - 02.2016
- Making phone calls
- Updating clients information
- Escalating information
- Researching new numbers
Door Shop/ Cut Light
Kolbe & Kolbe
04.2015 - 10.2015
- Cutting Bars
- Bending
- Hinging Doors
- Appling bars into door
Senior Line Attendee
Great Lakes Cheese
07.2012 - 04.2015
- Stacking cheese
- Packaging cheese
- Doing rework
- Putting cheese on film
- Doing paperwork for the line
Order Entry
Eastbay
12.2008 - 07.2012
- Placing order
- Order catalogs
- Gathering information
Receptionist
Bridge Community Health Clinic
04.2008 - 08.2008
- Collecting money
- Answering phones
- Scheduling appointments
- Pulling charts
Bank Teller
Brokaw Credit Union
01.2007 - 04.2008
- Managed money
- Respond to the phone
- Process transactions
- Filing paperwork
- Encoding checks
Merchandise and Customer Assistant
SEARS
09.2004 - 10.2007
- Organized fitting rooms and clothing department
- Distribute merchandise throughout clothing department
- Assembled shoes in shoe department
- Sell merchandise to customer
Cashier
Pick N Save
11.2002 - 09.2004
- Checkout groceries for customer
- Managed money
- Organized cash register
Education
H.S. Diploma -
Wausau West High School
06.2004
Undecided Major
University of Wisconsin-Marathon County
Skills
- Bilingual Hmong and English
- Customer service
- Strong communication skills
- Strong writing skills
- Strong listening skills
- Team player
- Excellent organizational skills
- Computer skills: Microsoft Word
- Computer skills: Excel
- Computer skills: Power Point
- Computer skills: Adobe
- ICD coding
- CPT coding
- Medical documentation
- Authorization verification
- Claim adjudication
Hobbies and Interests
- Diversity Club
- International Club
- Wausau West Orchestra
- First Hmong Missionary Alliance Church Youth Group Treasurer
- Music
- Volleyball
- Soccer
- Swimming
- Socializing
- Singing
Languages
English
Professional Working
Hmong
Limited Working
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