Priscilla Carter
Summary
Developed strong analytical and communication skills in fast-paced claims environment, constantly adapting to new challenges and regulations. Demonstrated ability to process complex information and deliver accurate solutions. Seeking to transition into new field, leveraging these transferable skills to drive positive outcomes and support business objectives.
Overview
6
6
years of professional experience
Work History
Fraud Claim representative/remote
Genpact
07.2023 - 12.2023
- Conducted analysis and promptly resolved escalated claims to ensure timely issue resolution
- Processed large volumes of claims efficiently in a fast-paced work environment
- Utilized advanced analytical skills to examine intricate claims, assess possible consequences, and establish appropriate strategies for resolution
- Streamlined the claim system by implementing updates that allowed for efficient claim status tracking and dissemination of vital details to other departments
- Investigated suspicious claims to identify potential fraud or abuse
- Resolved customer inquiries regarding claim status, payments, and denials promptly
Certified Medical Assistant
Internal Medicine Associates
02.2018 - 03.2020
- Scheduling procedures for patients, insurance verification, making appointments as well, checking inpatients, and checking patients out as well I am very familiar with the EMR system
- Obtained client’s medical history, medication information, symptoms, and allergies
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations
- Performed clerical duties, such as word processing, data entry, answering phones, and filing
- Collected and documented patient medical information such as blood pressure and weight
- Sanitized, restocked, and organized exam rooms and medical equipment
Education
No Degree - Medical Assistant
Florida Career College
Miami, FL09-2017
Skills
- Claims investigation
- Microsoft office
- Insurance regulations
- Trade policy
- Time management
Timeline
Fraud Claim representative/remote
Genpact
07.2023 - 12.2023
Certified Medical Assistant
Internal Medicine Associates
02.2018 - 03.2020
No Degree - Medical Assistant
Florida Career College
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