Dedicated Reimbursement Specialist with exemplary analyzation and negotiation abilities. Highly skilled in customer service and coverage evaluation. Specializing in Medicare Advantage insurance claims with a well-established knowledge of the general industry.
· 1 year of experience verifying insurance information, analyzing medical information and updating the data from insurances, analyzing claims and making disputes and appeals to denied procedures.
· Specialist with Medicare Advantage Coverages.
· Experience training new hires.
· Knowledge managing requests from agents and dealing with disputes.
· Conducted audits on invoices, resolved exceptions, and handled customer correspondence
· Collaborated with cross-functional teams to establish and exceed department goals.
· Investigation and improvement of procedures to be more efficient following the client guidelines
· Quality reviewer to know if the agents are following the procedures correctly and providing the improvement plan to get that area of improvement.
· Provide support and guide to the agents to keep the Quality and productivity required
· Update process with the client to improve the areas of the job.
· Analyze the payment sheet for the agents to get pay correctly.
Microsoft Excel proficiency