
Accomplished Medical Claims Processor with a proven track record at Zelis Healthcare, enhancing process efficiency by 15% and achieving a 95% customer satisfaction rating. Expert in claims adjudication and data management, coupled with exceptional communication skills. Demonstrated leadership in improving team performance and patient experience.
• Efficiently processed a high volume of medical claims with accuracy, ensuring compliance with company policies and regulatory standards.
• Performed extensive data entry tasks, inputting claims information into healthcare management software, resulting in a 20% reduction in processing errors.
• Collaborated with healthcare providers and insurance companies to resolve discrepancies, ensuring timely and accurate claims processing.
• Provided customer service support by handling inquiries and resolving issues related to claims, achieving a 95% customer satisfaction rating.
• Contributed to process improvement initiatives that led to a 15% increase in overall efficiency.
• Managed patient intake processes, including data entry of registration information, insurance verification, and documentation collection.
• Delivered high-quality customer service by addressing patient concerns and questions with empathy and professionalism, contributing to a positive patient experience.
• Maintained accurate and confidential patient records in compliance with HIPAA regulations, ensuring the integrity of patient data.
• Coordinated with healthcare providers to schedule appointments and follow-up visits, streamlining the intake process and reducing wait times.
• Trained and supervised junior staff, leading to improved team performance and patient satisfaction.
• Processed and adjudicated medical claims with a focus on accuracy and efficiency, reducing claim denial rates by 20%.
• Performed extensive data entry of claims information, ensuring that all records were up-to-date and accurate.
• Provided customer service support by responding to inquiries from patients and insurance companies, resolving issues promptly.
• Collaborated with the billing department to improve the claims submission process, resulting in faster payment cycles.
• Assisted in the preparation of reports and documentation for audits, ensuring compliance with industry standards.
Claims Processing & Adjudication
Data Entry & Management
Salesforce & CRM Management
CRM SQL & Data Analysis
Patient Intake & Registration
Customer Service & Communication
Healthcare Management Software (eg, Epic, Medisoft)
Insurance Verification & Coordination
HIPAA Compliance & Patient Privacy
Process Improvement & Efficiency
Team Leadership & Training
• HIPAA Compliance Certification