Stefanie McCoy
Fort Wayne,IN
Summary
Professional and prepared for role, bringing experience in medical claims review and analysis. Skilled in claims adjudication, compliance verification, and problem-solving with strong focus on team collaboration and achieving outcomes. Reliable and adaptable in dynamic environments, consistently demonstrating thoroughness and integrity. Proficient in medical claims processing, regulatory requirements, and effective communication.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Billing Clerk Authorization Specialist
ENT Associates
03.2025 - Current
- Processed patient billing and insurance claims efficiently, ensuring accuracy in all transactions.
- Resolved discrepancies in patient accounts through thorough investigation and effective communication with insurance providers.
- Handled account payments and provided information regarding outstanding balances.
Claims Analyst
Automated Group Administration, Inc. (AGA)
04.2024 - 03.2025
- Analyzed complex medical claims data to identify trends and optimize reimbursement strategies.
- Managed high-volume claims portfolios, ensuring timely processing and compliance with regulations.
- Developed training materials for new hires to facilitate onboarding and skill development of Medical Claims Analysts.
- Maintained regulatory compliance by staying current with industry guidelines, state laws, and federal regulations.
- Ensured accurate payments by meticulously reviewing medical records, invoices, and supporting documentation.
Claims Benefit Specialist
Aetna, a CVS Health Company
06.2023 - 04.2024
- Collaborated with cross-functional teams to resolve customer inquiries and streamline claims processes.
- Monitored claim processing timelines, implementing strategies to reduce delays and improve service quality.
- Reviewed policy coverage details thoroughly before making determinations on benefits eligibility for each unique claim scenario presented.
Claims Examiner
Metasis Information Systems
10.2022 - 06.2023
- Evaluated medical claims for accuracy, ensuring compliance with policies and regulations.
- Processed high-volume claims efficiently, maintaining stringent timelines and quality standards.
- Identified trends in claim denials, implementing corrective actions to minimize future issues.
Customer Service Representative
PHP of Northern Indiana
08.2020 - 10.2022
- Resolved customer inquiries and issues efficiently, enhancing overall satisfaction levels.
- Coordinated with internal departments to streamline communication processes and improve service delivery.
- Developed and maintained comprehensive knowledge of healthcare plans, benefits, and eligibility requirements.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
AR/AP Specialist -Part Time
Eagles Wings Air
11.2019 - 10.2022
- Managed accounts payable processes, ensuring timely and accurate invoice processing.
- Supported cash forecasting efforts by providing timely information on upcoming payment obligations, aiding in effective cash management strategies.
- Reconciled vendor statements and researched and corrected discrepancies.
- Matched invoices to checks, obtained signatures for checks and distributed checks accordingly.
Regional Dispatcher
Indiana State Police
01.2019 - 06.2019
- Coordinated multi-jurisdictional responses during emergency situations, enhancing operational efficiency across the region.
- Managed scheduling and dispatching of law enforcement resources, ensuring timely response to incidents.
- Oversaw communication between field units and command centers, facilitating real-time updates on incident developments.
- Established strong working relationships with local authorities, fostering collaboration in emergency response efforts.
Claims Adjuster
PAYFLEX / AETNA
11.2015 - 01.2019
- Collaborated with clients to gather necessary documentation and clarify details for efficient claim resolution.
- Analyzed complex claims to identify discrepancies and potential fraud, enhancing overall claim integrity.
- Implemented process improvements that streamlined workflows, reducing turnaround times for claim processing.
- Examined claims forms and other records to determine insurance coverage.
- Maintained compliance with state regulatory requirements through meticulous documentation and adherence to company policies.
Education
High school diploma or GED - Criminal Justice
Indiana Tech
Fort Wayne, INSkills
- Accurate data entry
- Client support
- Billing and invoicing
- Proficient in managing accounts payable and receivable
- Results-driven under deadlines
Certification
Driver's License
Languages
English
Native or Bilingual
Timeline
Billing Clerk Authorization Specialist
ENT Associates
03.2025 - Current
Claims Analyst
Automated Group Administration, Inc. (AGA)
04.2024 - 03.2025
Claims Benefit Specialist
Aetna, a CVS Health Company
06.2023 - 04.2024
Claims Examiner
Metasis Information Systems
10.2022 - 06.2023
Customer Service Representative
PHP of Northern Indiana
08.2020 - 10.2022
AR/AP Specialist -Part Time
Eagles Wings Air
11.2019 - 10.2022
Regional Dispatcher
Indiana State Police
01.2019 - 06.2019
Claims Adjuster
PAYFLEX / AETNA
11.2015 - 01.2019
High school diploma or GED - Criminal Justice
Indiana Tech
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