Reagan King
Houston,TX
Summary
Detail-oriented Health Insurance Claims Professional with experience in claims support, insurance verification, payment processing, customer service, and medical documentation. Skilled in reviewing eligibility, resolving claim issues, maintaining HIPAA compliance, and ensuring accurate, timely processing in fast-paced healthcare environments.
Overview
1
1
Language
1
1
Certification
8
8
years of professional experience
Work History
Patient Care Coordinator (PCC)
Ottobock Healthcare
Houston, TX
12.2025 - 05.2026
- Verified insurance eligibility, benefits, deductibles, and authorization requirements for patients before appointments.
- Coordinated patient intake by collecting demographic, insurance, and medical information while ensuring documentation was complete and accurate.
- Reviewed referrals, physician orders, and medical documentation to support insurance authorization and reimbursement requirements.
- Coordinated with providers, case managers, and insurance carriers regarding claim requirements and authorization status.
- Monitored authorization approvals, denials, and pending claims while communicating updates to patients.
- Reviewed patient documentation for claim accuracy before submitting information for insurance approval.
Claims Representative
OptumRx
Houston, TX
01.2023 - 12.2025
- Processed health insurance claims inquiries from members, providers, and pharmacies while ensuring timely issue resolution
- Verified member eligibility, insurance coverage, deductibles, copayments, and benefit information before processing requests.
- Reviewed claim status, explanation of benefits (EOBs), and payment information to assist members with claim-related questions.
- Researched and resolved denied, pending, and rejected claims by coordinating with claims processing and provider services teams.
- Assisted members with prior authorization requests and claim appeals by explaining required documentation and next steps.
- Investigated billing discrepancies, duplicate claims, and payment issues to ensure accurate claim resolution.
Administrative Assistant
Bp Oil Co
Houston, TX
03.2018 - 01.2024
- Managed scheduling and logistics for meetings and events, ensuring seamless communication.
- Prepared reports and presentations, facilitating informed decision-making processes.
- Developed and maintained filing systems, improving document retrieval time by 30%.
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Ensured confidentiality of sensitive information by adhering to privacy policies and implementing secure filing systems.
- Delivered excellent customer service through prompt responses to client inquiries, addressing concerns effectively, and building strong relationships.
- Ensured accurate record-keeping with diligent data entry and database management for vital company information.
- Fostered positive work environment through effective communication and professional relationship building among colleagues.
- Improved document organization with thorough file maintenance, archiving outdated records as necessary for efficient retrieval when needed.
- Coordinated office supply inventory management, proactively ordering necessary items before depletion to avoid workflow disruptions.
- Supported executive staff through scheduling meetings, coordinating travel arrangements, and preparing crucial documents.
- Optimized calendar management for executives by scheduling appointments strategically while considering priorities and minimizing conflicts.
- Assisted with human resources tasks such as updating employee files or submitting time-off requests per company policy guidelines.
- Collaborated on special projects by contributing research findings and coordinating event logistics.
- Facilitated collaboration within team by organizing regular meetings and tracking project progress.
Education
Associate's degree -
Lone Star College System
High school diploma - undefined
Langham Creek High School
Houston, TX06-2017
Skills
- Health Insurance Claims Processing
- Medical Claims Review
- Claims Investigation
- Payment Posting
- EOB (Explanation of Benefits)
- Medical Billing
- Insurance Verification
- HIPAA Compliance
- ICD-10 Coding Knowledge
- Customer Service
- Medicaid
- Medicare
Certification
- CPR Certification January 2022 to January 2028
- Driver's License
- Certified Medical Assistant
Languages
English - Fluent
Timeline
Patient Care Coordinator (PCC)
Ottobock Healthcare
12.2025 - 05.2026
Claims Representative
OptumRx
01.2023 - 12.2025
Administrative Assistant
Bp Oil Co
03.2018 - 01.2024
High school diploma - undefined
Langham Creek High School
Associate's degree -
Lone Star College System