Trinity Spencer
Memphis,TN
Summary
Experienced in the field of medical claims management. Possess thorough understanding and knowledge of health insurance policies, coding, billing procedures and compliance regulations. Strengths include efficiency in reviewing, analyzing and managing medical claims with accuracy. Notable impact made by reducing errors, streamlining processes and improving overall operational efficiency at previous employment.
Overview
8
8
years of professional experience
Work History
Claims Examiner
Everise
Remote
04.2023 - 12.2025
- Evaluated insurance claims for accuracy and compliance with company policies.
- Reviewed documentation to determine eligibility for benefits and coverage.
- Reviewed and resolved open claims and change orders to determine entitlement for additional payment.
- Maintained detailed records of all claims transactions and communications effectively.
- Performed data entry into the computer system to record information regarding claim status.
Medical Claims Processor
Home Instead Senior Care
Hybrid
11.2020 - 04.2023
- Processed medical claims for senior care services efficiently.
- Reviewed documentation for accuracy and compliance with regulations.
- Communicated with healthcare providers to resolve claim issues promptly.
- Maintained detailed records of claims and related correspondence.
- Utilized claims processing software to manage workflow effectively.
Claims Benefit Specialist
Walgreens Pharmacy
11.2017 - 12.2020
- Reviewed and processed benefit claims for accuracy and compliance.
- Communicated with clients to clarify claim details and gather necessary documentation.
- Collaborated with internal teams to resolve claim disputes and inquiries efficiently.
- Utilized claims management software to track and document case progress effectively.
- Educated clients on policy provisions, coverage options, and claim procedures clearly.
Education
Associate of Science -
Concorde Career College
Skills
- Claims evaluation
- Document review
- Eligibility determination
- Compliance assessment
- Claims processing software
- Benefit verification
- Data entry accuracy
- Electronic health records (EHR)
- Medical coding expertise
- Claims processing proficiency
- Medical terminology
- Microsoft office
Timeline
Claims Examiner
Everise
04.2023 - 12.2025
Medical Claims Processor
Home Instead Senior Care
11.2020 - 04.2023
Claims Benefit Specialist
Walgreens Pharmacy
11.2017 - 12.2020
Associate of Science -
Concorde Career College