Stephanie Acker
Dayton,OH
Summary
Dynamic Claims Management Coordinator with a proven track record at CareSource, excelling in employee training and problem-solving. Expert in Microsoft SQL, I streamlined claims processes, enhancing accuracy and productivity. Recognized for effective communication and mentoring, I fostered a collaborative team environment, significantly improving operational efficiency and resolving complex claims issues.
Overview
36
36
years of professional experience
Work History
Claims Management Coordinator
CareSource
08.2018 - Current
- Responsible for accurately selecting the correct provider and/or member on claims and timely following established guidelines for accuracy, quality, productivity and within established company goals.
- Ability to run Microsoft SQL software for audit hold claims and review and resolve these claims.
- Developed training and materials for new staff. Provide mentoring for new staff.
- Ability to create XC claims inventory sheet and assign work to team members.
- Review customer Service tickets for claims not in facets, resolve and report back to customer service and/or forward ticket to E-Business for review if needed.
- Identify, track and trend claims adjudication and provider load errors in order ot determine root causes and actions required to correct problems. Report to management any abnormalities.
- Open and track IT tickets to complete resolution for claims that require intervention.
Insurance Billing Specialist
Peltier Chiropractic
07.2014 - 08.2018
- Processed insurance claims accurately and efficiently, ensuring timely reimbursement for services rendered.
- Reviewed patient billing records to identify discrepancies and resolved issues promptly.
- Trained new staff on billing procedures and software usage, enhancing team productivity.
- Analyzed billing data to generate reports, providing insights for financial decision-making.
- Assisted colleagues during peak workload periods, demonstrating strong teamwork and commitment to overall departmental success.
- Assisted patients in understanding their coverage benefits, providing clear explanations and addressing any concerns or questions.
- Increased revenue collection by pursuing outstanding claims.
- Improved cash flow by promptly posting payments and reconciling accounts on a daily basis.
- Streamlined billing processes for improved efficiency through the electronic payment systems.
- Followed HIPAA guidelines and protecting important information on patients.
Insurance Processor
Cigna Insurance
06.1989 - 02.2018
- Processed insurance claims efficiently by verifying client information, reviewing coverage details, and ensuring accurate data entry.
- Reviewed documentation meticulously, identifying discrepancies to uphold accuracy in claim processing.
- Demonstrated exceptional time management skills by juggling multiple priorities while adhering to strict deadlines for claim submissions and other tasks.
- Contributed to a positive work environment by collaborating effectively with team members on various projects and tasks.
- Observed strict procedures to protect sensitive patient information, medical records, and payment data.
- Processed insurance claims efficiently, ensuring compliance with policy guidelines and regulatory requirements.
Education
Certificate of Completion - Diversified Health Occupations
Tri-Rivers Career Center
Marion, OH06-1989
High School Diploma -
Cardington Lincoln High School
Cardington, OH06-1989
Skills
- Employee training
- Teamwork and collaboration
- Problem-solving
- Time management
- Attention to detail
- Multitasking and organization
- Problem-solving abilities
- Reliability
- Effective communication
- Phone and email etiquette
- Microsoft office
- Self motivation
- Coaching and mentoring
Timeline
Claims Management Coordinator
CareSource
08.2018 - Current
Insurance Billing Specialist
Peltier Chiropractic
07.2014 - 08.2018
Insurance Processor
Cigna Insurance
06.1989 - 02.2018
Certificate of Completion - Diversified Health Occupations
Tri-Rivers Career Center
High School Diploma -
Cardington Lincoln High School
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