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, 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
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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