STEPHANIE KING
HENDERSON,NV
Summary
Effective Medical Claims Processor with strong background building rapport with providers to discuss claim status or claim denials. Driven performer equipped to handle multiple administrative tasks effectively. Exemplary worker with highly investigative skills when processing claims.
Overview
8
8
years of professional experience
Work History
Claims Specialist
Cerner
02.2018 - 07.2023
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
- Followed up with customers on unresolved issues.
- Submitted electronic/paper claims documentation for timely filing.
- Monitored and updated claims status in claims processing system.
- Verified patient insurance coverage and benefits for medical claims.
- Paid or denied medical claims based upon established claims processing criteria.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
Claims Specialist
Anthem Health Services
07.2015 - 01.2018
- Followed up with customers on unresolved issues.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Calculated adjustments, premiums and refunds.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Posted payments to accounts and maintained records.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Maintained confidentiality of patient finances, records, and health statuses.
Education
Associate of Science - Homeland Security
ICDC College - Huntington Park
Huntington Park, CA06.2015
High School Diploma -
Lancaster High School
Lancaster, CA06.2012
Skills
- Premium Calculations
- Electronic Health Records
- Corporate Policies and Procedures
- Regulatory Compliance Adherence
- HIPAA Procedures
- Document Scanning
- ICD-10 Coding
- Eligibility Requirements
- Prior Authorization Processing
- Electronic Claims Processing
- Patient Confidentiality
- Policy Update Coordination
Timeline
Claims Specialist
Cerner
02.2018 - 07.2023
Claims Specialist
Anthem Health Services
07.2015 - 01.2018
Associate of Science - Homeland Security
ICDC College - Huntington Park
High School Diploma -
Lancaster High School
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