Rabia Nabeel
Sacramento,CA
Summary
Experienced Claims Examiner with 5 years of expertise in data entry and account management. Proficient in accurate and efficient data processing, with strong skills in researching and evaluating customer information to ensure precision.
Overview
15
15
years of professional experience
Work History
Claims Examiner
CenCal Health
2024.04 - Current
- Conduct audits focused on manual pricing reviews and EDI remark assessments to ensure compliance
- Manage the end-to-end process of reviewing, pricing, and releasing claims, for both paper and electronic formats
- Monitor and evaluate Manual Review reports
- Investigate denied claims from Master Denial reports
- Audited medical claims and verified insurance eligibility
- Collaborate with the supervisory team to streamline processes, contributing to automation initiatives and quality improvement efforts.
Medical Claims Examiner
Gainwell Technology
2023.03 - 2023.11
- Audited medical claims and verified insurance eligibility
- Submitted medical bills and reviewed medical justification
- Overrode claims without key errors and corrected suspended claims
- Approved or denied insurance claims and handled claim pricing
- Uploaded lab results and documents into patient charts.
Suspension Claims Examiner
DXC Technology
2020.11 - 2022.06
- Reviewed insurance claim information and medical justification
- Audited and corrected suspended claims, approving or denying them as appropriate
- Managed claim pricing and handled overrides for non-key errors.
Care Coordinator Clerk
Sutter Health
2019.11 - 2020.11
- Performed data entry, patient authorization, and insurance verification
- Requested authorizations and managed clinic review requests
- Entered patient details accurately and logged information in Paycom.
Medical Biller
Advanced Home Health and Hospice
Sacramento , CA
2019.09 - 2019.10
- Verified insurance and eligibility
- Conducted audits using Excel
- Scheduled patients, answered phones, and performed data entry
- Uploaded lab results and documents into patient charts.
Customer Service Associate
Apple Store
Sacramento , CA
2015.12 - 2017.08
- Resolved customer issues with cell phones
- Promoted from MH2 to Line Lead 2
- Collaborated with the Shangi Team and earned Employee of the Month multiple times.
Customer Service Representative
Auntie Anne’s
Sacramento , CA
2015.05 - 2016.12
- Assisted customers with purchases efficiently
- Stocked and sanitized workstations
- Trained new employees and received a Good Customer Service Award.
Volunteer
Yolo County Food Alliance
West Sacramento , CA
2009.05 - 2011.05
Education
Medical Billing/Coding Certificate -
Carrington College
Sacramento, CA10.2019
High School Diploma -
River City High School
Sacramento, CA01.2013
Skills
- Typing Speed: 45 WPM
- Processing Claim Forms
- Assigning Medical Codes (ICD-10, HCPCS, CPT, CDT)
- Medical/Dental Terminology
- Anatomy and Physiology
- Harris Tracker
- Collection Techniques
- Patient Scheduling
- Microsoft Office Suite
- Electronic Health Records (EHR)
- EOB Interpretation
- Effective Communication Techniques
- HIPAA Compliance
- Insurance Verification
- Telephone Skills and Etiquette
Timeline
Claims Examiner
CenCal Health
2024.04 - Current
Medical Claims Examiner
Gainwell Technology
2023.03 - 2023.11
Suspension Claims Examiner
DXC Technology
2020.11 - 2022.06
Care Coordinator Clerk
Sutter Health
2019.11 - 2020.11
Medical Biller
Advanced Home Health and Hospice
2019.09 - 2019.10
Customer Service Associate
Apple Store
2015.12 - 2017.08
Customer Service Representative
Auntie Anne’s
2015.05 - 2016.12
Volunteer
Yolo County Food Alliance
2009.05 - 2011.05
Medical Billing/Coding Certificate -
Carrington College
High School Diploma -
River City High School
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