Sherri Owens
Wilson-McShane
Las Vegas,NV
24
years of professional experience
Detail-oriented Healthcare Professional experienced in medical claims analysis and resolution. Streamlined claim processing workflows, ensuring adherence to industry regulations and enhancing accuracy in project management. Focused on collaboration and adaptability to evolving demands, contributing to optimal team outcomes.
Work History
Medical Claims Analyst
2 Years 6 Months- Developed training program for new staff on claim submission methods, documentation requirements, and coding practices.
- Investigated appeals from providers regarding denied or underpaid claims.
- Conducted investigations into provider appeals on denied or underpaid claims to identify resolution paths.
- Trained new staff members on proper claim submission methods, documentation requirements, coding practices.
- Conducted quality control reviews of work completed by team members.
- Coordinated with healthcare providers to address and resolve outstanding claims issues.
- Performed data entry into multiple computer systems related to health insurance benefits and claims processing.
Flight Attendant
7 Years 6 Months- Elevated passenger satisfaction through exceptional in-flight service and attentive response to individual needs.
- Ensured timely departures by assisting with boarding procedures and efficiently stowing luggage.
- Maintained a safe cabin environment by conducting pre-flight safety checks and adhering to FAA regulations.
- Strengthened customer loyalty with personalized interactions, promptly addressing concerns and resolving issues.
- Collaborated with fellow crew members to deliver a seamless travel experience for passengers on domestic and international flights.
- Exhibited flexibility and adaptability during schedule changes and delays while maintaining a positive demeanor.
Quality Assurance Analyst
13 Years 10 Months- Streamlined workflows and implemented new software to enhance claim processing efficiency.
- Reduced claims adjudication error rates through meticulous attention to detail and thorough documentation review.
- Achieved timely resolution of complex claims cases by collaborating with medical professionals and legal teams.
- Acquired comprehensive understanding of medical terminology, coding systems, and billing procedures to ensure accurate claim processing.
- Ensured accuracy of claim payments by conducting thorough audits and identifying areas for improvement.
- Reduced claim overpayments with comprehensive analysis of billing discrepancies and adherence to company policies.
Education
Associate of Science - Chemistry
Skills
Claims processing
Claims Coding Accuracy
Claims Quality Control
HIPAA
Regulatory knowledge
Medical Terminology
Clinical terminology
Issue Resolution
Critical Decision-Making
Staff Training Programs
Verbal and Written Communication
Insurance Claim Regulations
Timeline
Medical Claims Analyst
Wilson-McShane
03.2024 - CurrentRead More
Flight Attendant
Frontier Airlines
04.2016 - 10.2023Read More
Quality Assurance Analyst
Arkansas Bluecross & Blue Shield
06.2002 - 04.2016Read More
University of Arkansas At Little Rock
Associate of Science from Chemistry
Read More