Summary
Overview
Work History
Education
Skills
Platforms & Systems
Timeline
Generic

Patricia Cochran

Montgomery,AL

Summary

Experienced and dedicated professional with a strong background in customer service and five years of remote work experience in the DME industry. Possess extensive knowledge in CPAP/BiPAP equipment and medical documentation review. Experienced with Medicare guidelines, and prior authorization requirements for commercial healthcare plans. Demonstrated track record of productivity, meticulous attention to detail, and ability to work independently with minimal supervision. Seeking a challenging role to effectively leverage skills and expertise in contributing to team and organizational success.

Overview

6
6
years of professional experience

Work History

Medical Claims Specialist

Concentrix
04.2024 - Current
  • Reduced errors in claims submissions through meticulous attention to detail and thorough review processes.
  • Improved claim processing efficiency by streamlining workflows and implementing best practices.
  • Expedited claim resolution times with proactive communication between patients, providers, and insurance companies.
  • Verified patient insurance coverage and benefits for medical claims.
  • Used administrative guidelines as resource or to answer questions when processing medical claims.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
  • Reduced errors in claims submissions through meticulous attention to detail and thorough review processes.
  • Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.

Medical Documentation Reviewer

LINCARE LTD
06.2020 - 02.2024
  • Facilitated timely insurance claims processing through diligent examination and validation of medical documents.
  • Streamlined the process for addressing missing or incomplete information in patient records by developing efficient follow-up procedures with healthcare providers.
  • Demonstrated exceptional attention to detail in the identification and correction of errors within patient records, ultimately contributing to improved care outcomes.
  • Improved patient record accuracy by meticulously reviewing and updating medical documentation.
  • Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
  • Maintained patient confidence by keeping patient records information confidential.
  • Maintained patient records in compliance with security regulations.
  • Maintained accuracy, completeness, and security for medical records and health information.
  • Followed up with medical staff regarding missing information in patient records.
  • Utilized electronic medical record systems to store, retrieve and process patient data.
  • Verified accuracy of patient information in medical records.
  • Tracked and monitored requests for medical records release.
  • Researched and resolved medical record discrepancies.

Customer Experience Champion

Everise / Centene Medicare PDP Part D Only
02.2019 - 06.2021
  • Company Overview: Customer experience Champion in the pharmacy dept. For WellCare Medicare pdp only.
  • Investigated customer complaints and escalated issues to address critical requests.
  • Documented customer interactions in internal database to maintain customer service history details.
  • Actively participated in team meetings, sharing ideas and suggestions for process improvements that enhanced service quality and efficiency.
  • Handled challenging situations with empathy and patience, demonstrating a commitment to customer satisfaction at all times.
  • Improved first call resolution rates with thorough product knowledge and efficient problem-solving skills.
  • Responded to high volume of incoming calls utilizing listening and communication skills to identify customer problems, needs, and opportunities.
  • Assisted members with their prescription drug plan premiums, payments, provided complete and accurate information in reference to deductibles and current year formulary provided by CMS

Education

Associate in Applied Science - Health Information Technology

Wallace State Community College
Hanceville, AL
05-2025

Skills

  • Claims processing
  • Insurance verification
  • HIPAA
  • EOB analysis
  • Medical software navigation
  • Claim denials management
  • Claim appeals handling
  • Customer service
  • Medical record review
  • Medical terminology
  • Electronic health records (EHR)
  • ICD codes
  • Time management
  • Attention to detail
  • Multitasking
  • Claims investigation
  • Reliability

Platforms & Systems

CITRIX

LITE

AS400

RUMBA

ASD

GPS 

SALESFORCE

PARACHUTE

McKESSON 

MEDCOMPASS

ACTION CODES

TEAMS

MICROSOFT 365 (EXCELL, POWER POINT)

AVAILITY



Timeline

Medical Claims Specialist

Concentrix
04.2024 - Current

Medical Documentation Reviewer

LINCARE LTD
06.2020 - 02.2024

Customer Experience Champion

Everise / Centene Medicare PDP Part D Only
02.2019 - 06.2021

Associate in Applied Science - Health Information Technology

Wallace State Community College

Similar Profiles

CREATE PROFILE
Patricia Cochran