Radiance Perot

• Review and process high-volume healthcare claims and account information while meeting established productivity and accuracy expectations.
• Analyze claim documentation, payer correspondence, account history, and supporting information to determine appropriate follow-up actions.
• Navigate Epic and supporting electronic systems to research claim status, verify information, and update account records.
• Identify claim discrepancies, missing information, and processing issues requiring correction, additional review, or escalation.
• Enter and verify claim and account information while maintaining detailed and accurate electronic documentation.
• Follow established procedures and account-specific workflows when processing assigned claims.
• Escalate complex account issues to appropriate internal teams when additional review or action is required.
• Independently manage a high-volume remote workload while meeting daily and weekly production expectations.

• Performed quality-control reviews of patient documentation and clinical information to ensure accuracy and completeness.

• Identified errors, missing information, and discrepancies requiring correction or additional review.
• Evaluated information against established SOPs and quality standards before completing assigned work.
• Documented findings clearly and accurately to support appropriate follow-up and resolution.
• Maintained consistent accuracy while managing high-volume workloads and productivity expectations.
• Collaborated with internal teams to resolve quality and documentation concerns.

• Processed high volumes of healthcare claim information from source documents into electronic systems.
• Entered and verified demographic, billing, and claim information across multiple databases.
• Reviewed information for accuracy and identified discrepancies requiring correction.
• Prioritized assignments while meeting established productivity and turnaround expectations.
• Maintained accurate and confidential records while working independently.

• Researched and verified information across multiple internal systems and electronic sources.
• Reviewed records for completeness, accuracy, and consistency before processing.
• Identified missing or conflicting information and documented discrepancies for follow-up.
• Maintained accurate electronic records while meeting established quality and productivity requirements.

• Supported patients and health plan members through chat and electronic communication while providing respectful and professional assistance.
• Listened carefully to patient and member concerns, researched available information, and provided clear guidance based on established procedures.
• Communicated with individuals from diverse backgrounds while maintaining patience, empathy, and professionalism.
• Documented interactions accurately in electronic systems to support continuity and appropriate follow-up.
• Protected sensitive patient information and maintained HIPAA/PHI confidentiality throughout all interactions.

• Supported patients and members with healthcare and billing-related concerns through inbound and electronic communication channels.
• Used active listening and clear communication to understand concerns and provide appropriate information and next steps.
• Maintained professionalism when assisting individuals with sensitive, complex, or frustrating situations.
• Documented interactions accurately and escalated issues requiring additional assistance to appropriate teams.
• Maintained strict confidentiality and HIPAA compliance when handling sensitive patient information.