Location: Richardson, United States
Member since: September 2012
Complete high level reports and audits to ensure company is running properly daily. Provide management with daily volume of claims and statements extracted from TES to Bar, including categorization, and daily monetary cash balances.<br />Provide and participate in performance training of employees. Recommend employee improvements, write step by step Policy & Procedures for selected departments, provide employee coaching, and report errors to supervisors weekly. <br />Perform daily analysis ensuring all elect
Verify, key, and process submitted Medicaid, CHIP Perinate, and Physical Therapy UB92 and HCFA claims according current and relevant State Rules and Regulations. <br />Exceed production averages and accuracy minimums for payments and denials. <br />Communicate with providers and members through clear and concise correspondence. <br />Monitor and follow up on pending claim activity requiring additional information timely and accurately. <br />Take inbound member, client, and broker calls. Enforce HIPPA laws with each p
Kelly Services (Cigna) - April 08 - July 08 - Claims Examiner<br />Verify, key, and audit Workers Compensations claims for all 50 states based on Rules and Regulations. Determine that each incident is a work related prior to payment or denial. Correspond with providers via telephone and written/automated generated letters as needed. Maintain speed, accuracy, and turnaround time. <br />Progressive Staffing (Ameripath) - August 08 - August 08 - Data Entry Operator<br />Accurately key laboratory bills in a producti
Injury Management Organization
Verify, key, and audit all incoming claims based on the State of Texas Workers Compensation Rules and Regulations. <br />Correspond with providers via telephone or mail regarding payments and denials. <br />Process specialty claims and accounts. <br />Train, audit, and coach incoming employees.<br />Maintain all accuracy guidelines set by management, meet all deadlines, and turnaround times.
Verify, key, and audit Workers Compensation Claims for according to TX/ FL Rules and Regulations. <br />Determine that each claim is in response to a true work related incident<br />Contact providers as needed via telephone or written correspondence. <br />Train, audit, and coach incoming employees. <br />Maintain speed, accuracy, and turnaround time on each claim.