Tasha Jaurequi
Downey,CA
Summary
Claims Examiner with 19 years of experience in insurance claims evaluation, ensuring compliance with policy terms and enhancing financial accuracy. Expertise in billing coding, insurance verification, and data management systems such as Epic and Next Gen. Proven ability to streamline processes and resolve complex cases efficiently while maintaining high customer satisfaction. Experienced in managing diverse caseloads and collaborating effectively with stakeholders to deliver fair outcomes.
Overview
11
11
years of professional experience
Work History
Claims Examiner
Kaiser Permanente
Remote
04.2018 - Current
- Analyzed claims and reviewed documents to establish their validity.
- Authorized payments for medical services and lost wages related to injuries.
- Conducted investigations by gathering information, analyzing evidence, and requesting police reports and medical records.
- Resolved issues through effective communication with customers and insureds to enhance service quality.
Patient Financial Services Representative
PIH Health
Whittier
01.2017 - 03.2019
- Patient Registrations, Verified insurance eligibility, and benefits for accurate billing and coding.
- Performed data entry and customer service to assist customers with financial needs.
- Conducted quality assurance on accounts to ensure compliance with industry standards.
- Trained new employees on procedures and best practices for effective operations.
Patient Biller 3/Senior Financial Analyst
UCLA Health
Los Angeles
08.2014 - 12.2017
- Provided cash quotes for medical services and managed collections effectively.
- Verified insurance eligibility and benefits, explaining details to patients clearly.
- Processed claims and requested necessary medical records for service authorization.
- Handled incoming calls from providers and patients, ensuring efficient communication.
Education
High School Diploma -
Parkridge Private School
Long Beach, CASkills
- Microsoft Office Suite
- Data management and entry
- Customer service excellence
- Case management and insurance verification
- Billing and coding expertise
- Training and development
- Organizational skills
- Time management strategies
- Effective communication skills
- Team leadership and collaboration
- Analytical thinking and problem solving
- Negotiation and project management
- Financial reporting accuracy
- Attention to detail
Timeline
Claims Examiner
Kaiser Permanente
04.2018 - Current
Patient Financial Services Representative
PIH Health
01.2017 - 03.2019
Patient Biller 3/Senior Financial Analyst
UCLA Health
08.2014 - 12.2017
High School Diploma -
Parkridge Private School