Summary
Overview
Work History
Education
Skills
Timeline
Generic

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
04.2024 - 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
03.2023 - 11.2023
  • 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
11.2020 - 06.2022
  • 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
11.2019 - 11.2020
  • 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
09.2019 - 10.2019
  • 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
12.2015 - 08.2017
  • 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
05.2015 - 12.2016
  • 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
05.2009 - 05.2011

Education

Medical Billing/Coding Certificate -

Carrington College
Sacramento, CA
10.2019

High School Diploma -

River City High School
Sacramento, CA
01.2013

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
04.2024 - Current

Medical Claims Examiner

Gainwell Technology
03.2023 - 11.2023

Suspension Claims Examiner

DXC Technology
11.2020 - 06.2022

Care Coordinator Clerk

Sutter Health
11.2019 - 11.2020

Medical Biller

Advanced Home Health and Hospice
09.2019 - 10.2019

Customer Service Associate

Apple Store
12.2015 - 08.2017

Customer Service Representative

Auntie Anne’s
05.2015 - 12.2016

Volunteer

Yolo County Food Alliance
05.2009 - 05.2011

Medical Billing/Coding Certificate -

Carrington College

High School Diploma -

River City High School

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Rabia Nabeel