TAKARA RAY
Columbus,OH
Summary
Energetic Insurance Professional experienced in managing member relationships and resolving claims. Delivered high-quality insurance solutions through strong collaboration and adaptability, ensuring reliable performance. Built trust with clients by providing guidance and financial advice tailored to their needs.
Overview
1
1
Certification
6
6
years of professional experience
Work History
Dual Insurance Specialist
Healthcare Support Staffing/Buckeye Health
Remote In Columbus OH
08.2025 - 07.2026
- Analyzed insurance claims for medicaid and medicare (Dual) members to ensure compliance with healthcare regulations and policies.
- Implemented process improvements that enhanced accuracy in claims processing and reduced turnaround times.
- Analyzed insurance claims to ensure compliance with healthcare regulations and policies.
- Mentored junior staff on best practices for insurance claim submissions and dispute resolutions.
- Developed relationships with members through effective listening techniques, empathy, and proactive problem solving
- Utilized knowledge of products and services to answer questions accurately and effectively.
Survivor Benefits Specialist
Ohio Public Employees Retirement System (OPERS)
Columbus, OH
03.2023 - 07.2025
- Support families by processing retirement savings once a member or beneficiary is deceased
- Investigate and research the manner of how the member or beneficiary has passed
- Communicate and provide support to beneficiaries filling out the proper paperwork to claim benefits
- Verify previous documentation from members appointing Trustees or Estate Administrators
- Verify coordination of benefits, if benefits are to be paid to a single beneficiary or by automatic succession
Customer Experience Rep II
Molina Healthcare Inc
Columbus, OH
08.2021 - 09.2022
- Support providers (doctors, nurses, third parties) by answering calls with questions on Medicaid and Medicare claims processes
- Communicate and provide support to providers filing appeals or grievances for denied claims
- Answer questions regarding member eligibility, insurance status, and authorizations
- Research Coordination of Benefits for providers to ensure claims are routed correctly for payment
- While using different systems investigate claim denials and advise providers on the next options for claim payments
Healthcare Billing and Follow-up Specialist
Trinity Health System
Columbus, OH
02.2020 - 08.2021
- Analyzed and researched claim status and issues for commercial, Medicaid, Medicare, and workers compensation claims to resolve discrepancies efficiently
- Communicated with insurance payers to facilitate timely adjudication of claims, ensuring accurate processing
- Analyze and research claim status and issues for commercial, Medicaid, Medicare, and workers compensation claims
- Research Coordination of Benefits for patients with multiple insurance
- Researched claim payments from various insurances to reconcile accounts and verify outstanding balances
- Facilitated the transfer of outstanding balances to streamline collections to self-pay patients for collections
- Rebilled or submitted corrected healthcare claims.
Education
Diploma - Health Science Medical Billing/Coding
Purdue Global University
Remote In Columbus OH. 06-2017
Skills
- Medical Billing
- Medical Coding
- Billing management
- ICD-10
- ICD-9
- Claims management
- Insurance Verification
- Billing
- Customer billing
- Claims gathering
- Medical Terminology
- Medical Office Experience
- Healthcare Management
- Financial Services
- Medicaid
- Public assistance programs
- Claims Advocacy
- Excel
- Claims processing
- Customer outreach
- Billing inquiries
- Claims investigation
- Training & Development
- Authorization processing
- Upselling
Certification
Medical Billing and Coding, Present
Personal Information
Work Permit: Authorized to work in the US for any employer
Timeline
Dual Insurance Specialist
Healthcare Support Staffing/Buckeye Health
08.2025 - 07.2026
Survivor Benefits Specialist
Ohio Public Employees Retirement System (OPERS)
03.2023 - 07.2025
Customer Experience Rep II
Molina Healthcare Inc
08.2021 - 09.2022
Healthcare Billing and Follow-up Specialist
Trinity Health System
02.2020 - 08.2021
Diploma - Health Science Medical Billing/Coding
Purdue Global University