Overview
Work History
Education
Skills
Certification
Timeline
Generic

Patrick Horn

Tucson,AZ

Overview

10
10
years of professional experience
1
1
Certification

Work History

Claims Analyst

Centene
10.2019 - Current
  • Prepared reports summarizing trends in appeal outcomes and identified areas for improvement.
  • Participated in meetings with internal departments or external vendors as necessary to discuss disputed claims or other related matters.
  • Analyzed claim data to identify trends and recommend process improvements.
  • Point of Contact for Health plans process of handling claims.
  • Maintained records of all appeal activities in a timely manner.
  • Resolved appeals through negotiations with insurance companies, attorneys, and other parties.
  • Compiled and documented information for appeal cases.
  • Tracked progress of ongoing appeals cases using computer software systems.

Collection Specialist

Shared Services Center
10.2017 - 01.2019
  • Follow up on past due accounts for recoupment, coordination of benefits (COB), submitting requests for medical records, high dollar claims, authorizations, and adjustments
  • Followed all company procedures to keep data confidential.
  • Managed workload effectively to ensure timely processing of claims within designated deadlines.
  • POC for new employees for help resolving accounts, documentation requirements, technical issues and general team support
  • Managed escalated cases involving high-value claims or multiple parties involved.
  • Ensured compliance with federal and state regulations governing insurance industry operations.
  • Verified documents to ensure accuracy of information provided by customers.
  • Advised customers on filing requirements, documentation needed, and other matters pertaining to their claims.
  • Investigated complex claims by gathering information from various sources to assess validity.

Pharmacy Tech Trainee

Convergys
01.2016 - 01.2017
  • Displayed strong telephone etiquette, effectively handling difficult calls.
  • Identified needs of customers promptly and efficiently.
  • Maintained records of customer interactions, transactions, comments and complaints.

Department Lead/Machinist

Halyard Health
01.2015 - 01.2016
  • Medical Lab Assembler for oral care department; clean room environment procedures
  • Prepping of inventory; boxes, lids, cups, bags, trays Including Re-word
  • Data entry including daily file and record documentation
  • Coordinate and maintain supply inventory for daily production runs
  • Coordinated with the maintenance department for machine failure
  • Trained in Personal Protection Equipment, Hazardous Material
  • Monitored tote shelf life in compliance to be able to use
  • Logged maintenance issues to the Maintenance Department
  • Measuring level of peel lid testing and pressure testing.

Education

Diploma -

Sahuaro High School
01.2011

Skills

  • Claims History Analysis
  • Complaint Resolution
  • Customer Service Excellence
  • Customer Insight
  • Computer Skills
  • Critical Thinking
  • Coaching and Mentoring
  • Time Management
  • Communication Skills
  • Detail Oriented
  • Venipuncture
  • Donor screening
  • Sanitation and sterilization
  • Blood collection
  • Patient Care
  • HIPAA Compliance
  • Data Entry

Certification

Phlebotomy Technician Certification (07/2024)

Timeline

Claims Analyst

Centene
10.2019 - Current

Collection Specialist

Shared Services Center
10.2017 - 01.2019

Pharmacy Tech Trainee

Convergys
01.2016 - 01.2017

Department Lead/Machinist

Halyard Health
01.2015 - 01.2016

Diploma -

Sahuaro High School

Similar Profiles

CREATE PROFILE
Patrick Horn