SHERYL FISCHER
Haslet,TX
Summary
Detail-oriented claims professional with 10+ years of experience reviewing medical records, verifying eligibility, and investigating complex claims. Skilled in applying policy guidelines, documenting case activity, and managing escalated files with accuracy, confidentiality, and sound judgment. Focused on improving claim outcomes and compliance.
Overview
12
12
years of professional experience
Work History
Claims Analyst
United Healthcare
Haslet, Texas
04.2015 - Current
- Investigated claim documentation for accuracy and compliance
- Applied UnitedHealthcare policy guidelines during claim reviews
- Assessed medical records for coverage eligibility and benefit accuracy.
- Verified member benefits and eligibility for claim processing
- Documented claim activity and maintained accurate records to ensure compliance and facilitate timely claims processing
- Conducted investigations to gather evidence supporting claims resolution, enhancing accuracy and reliability of claim outcomes
- Managed escalated cases involving high-value claims or multiple parties, ensuring thorough resolution and customer satisfaction.
- Maintained accurate records of all claim activities in accordance with company policies.
- Verified documents to ensure accuracy of information provided by customers.
- Followed all company procedures to keep data confidential.
Education
Insurance And Medical Coding
CHCP
Fort Worth, TX01-2014
High School Diploma -
Seward Park High School
New York, NY06-1973
Skills
- Claims processing
- Claims adjudication
- Claims analysis
- Benefits verification
- Policy compliance
- Medical records review
- Insurance processing
Affiliations
- Quilter, Tax preparer
Timeline
Claims Analyst
United Healthcare
04.2015 - Current
Insurance And Medical Coding
CHCP
High School Diploma -
Seward Park High School