Tira Kincheon
Texas
Summary
Professional with experience in healthcare administration, specializing in processing and managing medical claims. Skilled in data analysis, claim adjudication, and ensuring compliance with industry regulations. Strong focus on teamwork and achieving results through effective communication and adaptability to changing needs. Reliable and efficient in handling high volumes of claims.
Overview
5
5
years of professional experience
4
4
years of post-secondary education
Work History
Medical Claims Processor/CSR
Maximus
10.2024 - 11.2025
- Processed high volumes of medical claims accurately and efficiently under tight deadlines, ensuring prompt payment for services rendered.
- Researched and resolved complex medical claims issues to support timely processing.
- Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation protocols and third party requirements regarding billing.
- Maintained accurate patient records with diligent data entry and effective communication with healthcare professionals.
Claims Adjuster
API IMAGE
12.2022 - 10.2024
- Negotiated favorable settlements with claimants, attorneys, and other insurance carriers to minimize financial risk for the company.
- Developed positive relationships with policyholders, fostering trust through transparency during the claim process.
- Examined claims forms and other records to determine insurance coverage.
- Improved customer satisfaction by providing timely updates and resolutions to their claims inquiries.
Claims Specialist
IRS
03.2021 - 12.2022
- Enhanced customer satisfaction with timely communication, empathy, and clear explanations of claim outcomes.
- Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
- Provided exceptional customer service by addressing client inquiries promptly and professionally.
- Enhanced claim processing efficiency by streamlining workflows and implementing best practices.
Education
High School Diploma -
LBJ Early College High School
Austin , TX 08.2010 - 06.2014
Skills
- Customer Service
- Inbound and Outbound Calling
- Insurance Verification
- Typing Proficiency 65 WPM
- Eligibility Determination
- Medical Billing Software
- ICD-10 proficiency
- Claim Denial Resolution
- Microsoft Excel
- Claims Processing
- Call Center Experience
- Data Entry and Analysis
Timeline
Medical Claims Processor/CSR
Maximus
10.2024 - 11.2025
Claims Adjuster
API IMAGE
12.2022 - 10.2024
Claims Specialist
IRS
03.2021 - 12.2022
High School Diploma -
LBJ Early College High School
08.2010 - 06.2014