Thelma Butcher
Chesterfield,VA
Overview
28
28
years of professional experience
Work History
Senior Claims Processor
Wellmed
, Texas
09.2022 - Current
- Investigated properties to determine extent of damage and estimate repair costs.
- Collaborated with claims department and industry anti-fraud organizations to resolve claims.
- Followed up on potentially fraudulent claims initiated by claims representatives.
- Reported policy changes and company conditions affecting customer satisfaction.
- Modeled exceptional customer service skills and appropriate diagnostic sales techniques to team members.
- Evaluated accuracy and quality of data entered into agency management system.
- Established positive and trusting relationships with injured clients, administering efficient customer service and processing claims quickly.
- Coordinated with contracting department to resolve payer issues.
- Analyzed information gathered by investigations to report findings and recommendations.
- Communicated verification and authorization status updates with [Type] department to facilitate decision-making for patient admissions and insurance coverage.
- Processed and recorded new policies and claims.
Scheduling Coordinator
Bon Secours
Richmond , VA
04.2014 - 09.2022
- Contacted hospitals to confirm patients medical histories and prevent inaccurate diagnoses and treatments.
- Managed office logistics by scheduling appointments, maintaining files and collecting payments.
- Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
- Obtained payments from patients and scanned identification and insurance cards.
- Increased customer satisfaction by resolving issues.
Claims Processor
Anthem
Richmond, Virginia
08.2002 - 04.2022
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Evaluated and settled complex insurance claims in strict timeframes.
- Collaborated with claims department and industry anti-fraud organizations to resolve claims.
- Analyzed information gathered by investigations to report findings and recommendations.
- Evaluated accuracy and quality of data entered into agency management system.
- Followed up on potentially fraudulent claims initiated by claims representatives.
- Maintained confidentiality of patient finances, records and health statuses.
Education
Associate of Arts - Liberal Arts And General Studies
Long Island University
Brooklyn New York05.1997
Skills
- Transactions reconciliation
- Claims review
- Claims
- Great mathematical skills
- Patient contact
- Understanding of medical terms
- Excellent administrative abilities
- Reporting skills
- Insurance coverage verification
- Data integrity
- Proficient in epic, connectcare, word, excel, data entry
Timeline
Senior Claims Processor
Wellmed
09.2022 - Current
Scheduling Coordinator
Bon Secours
04.2014 - 09.2022
Claims Processor
Anthem
08.2002 - 04.2022
Associate of Arts - Liberal Arts And General Studies
Long Island University
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