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Reimbursement Specialist Insurance Claims

Location:
Charlotte, NC
Posted:
April 25, 2024

Contact this candidate

Resume:

TERI TAYLOR

Charlotte, NC

ad49z6@r.postjobfree.com

+1-704-***-****

Highly skilled Reimbursement Specialist with 4 years of experience in managing insurance claims and reimbursement processes. Demonstrated expertise in collecting and reviewing patient insurance benefit information, assisting with insurance forms, and ensuring timely reimbursement. Strong attention to detail and ability to navigate complex insurance policies. Seeking to leverage my skills and knowledge to contribute to the success of your company. Work Experience

Reimbursement Specialist

CareMetx, LLC - Charlotte, NC

December 2023 to Present

• Collect and review patient insurance benefit information, following standard operating procedures (SOP) of the program.

• Assist physician office staff and patients in completing and submitting insurance forms and program applications.

• Ensures timely completion and submission of all required insurance forms for reimbursement.

• Verify insurance coverage and eligibility for patients, maintaining accurate and up-to-date information.

• Collaborate with insurance companies and healthcare providers to resolve issues and discrepancies in reimbursement claims.

• Stays updated with industry regulations and changes in insurance policies to provide accurate assistance to patients and healthcare professionals.

• Communicates effectively with patients, healthcare providers, and insurance companies to ensure a smooth reimbursement process.

• Employ problem-solving skills to address challenges and obstacles during the reimbursement process. Skills:

• In-depth knowledge of insurance policies and procedures

• Strong attention to detail and accuracy

• Excellent communication and interpersonal skills

• Proficient in completing and submitting insurance forms

• Problem-solving and critical thinking abilities

• Ability to work independently and as part of a team Reiki Master Instructor and Practitioner

Heavenly Butterfly Boutique - Charlotte, NC

January 2017 to Present

- Conduct Reiki sessions to promote relaxation, reduce stress, and improve overall well-being, creating a nurturing and healing environment.

- Teach and certify individuals in Reiki techniques and principles, empowering them to become skilled practitioners.

- Develop and implement customized Reiki plans based on clients' needs and objectives, ensuring personalized and effective healing experiences.

- Maintain accurate records of client and student progress and provide regular feedback and support, fostering growth and development.

Life Coach

Heavenly Butterfly Boutique - Charlotte, NC

January 2015 to Present

- Conduct one-on-one coaching sessions to help clients identify and achieve their personal and professional goals, providing guidance and support.

- Develop and implement customized coaching plans based on clients' needs and objectives, ensuring tailored and effective coaching experiences.

- Utilize motivational speaking and empathetic listening to inspire and empower clients, fostering a positive and transformative coaching environment.

- Maintain accurate records of client progress and provide regular feedback and support, tracking and celebrating their achievements.

Intake Specialist for Social Security Benefits

Heard and Smith, LLP - Charlotte, NC

March 2023 to November 2023

- Conduct interviews with clients to determine eligibility for social security benefits, ensuring accurate and thorough assessments.

- Assist clients with completing and submitting necessary paperwork and documentation, streamlining the application process.

- Communicate with government agencies and other stakeholders to ensure timely and accurate processing of benefits, maintaining strong professional relationships.

- Maintain accurate records of client interactions and progress, ensuring data integrity and confidentiality.

- Provide consulting services to clients, offering guidance and support to help them navigate the social security benefits system.

- Conduct needs assessments and develop customized solutions to meet client needs, ensuring personalized and effective assistance.

- Develop and implement marketing strategies to increase brand awareness and drive sales, utilizing innovative approaches.

- Conduct market research to identify trends and opportunities for growth, staying ahead of industry developments.

- Create and manage social media campaigns to engage with customers and promote products/services, enhancing brand visibility.

- Analyze data and metrics to measure the effectiveness of marketing and consulting initiatives, making data-driven decisions.

- Provide regular reports and updates to senior management on project status and performance, demonstrating strong communication skills.

Benefits Specialist

Lash Group, An AmerisourceBergen Company - Fort Mill, SC November 2020 to February 2021

1. Administering employee benefits programs: I was responsible for managing and administering various employee benefits programs, such as health insurance, dental insurance, vision insurance, life insurance, disability insurance, retirement plans, and flexible spending accounts. This involved ensuring accurate enrollment, processing changes, and resolving any issues or discrepancies. 2. Providing benefits information and guidance: I served as a point of contact for employees, providing them with information and guidance on their benefits options, coverage details, and eligibility requirements. I effectively communicated complex benefits information in a clear and concise manner, ensuring employees understood their options and made informed decisions. 3. Conducting benefits orientations and training: I conducted benefits orientations for new hires, explaining the available benefits options and assisting them with the enrollment process. Additionally, I organized and conducted training sessions to educate employees on the various benefits programs and any updates or changes.

4. Managing open enrollment process: I coordinated and managed the annual open enrollment process, which involved communicating important dates, distributing enrollment materials, and assisting employees with their benefit elections. I ensured that all employees had access to the necessary information and resources to make informed decisions during the open enrollment period. 5. Resolving benefits-related issues: I proactively addressed and resolved benefits-related issues and inquiries from employees, such as claims disputes, coverage questions, and billing discrepancies. I worked closely with insurance providers, vendors, and internal stakeholders to resolve issues in a timely and satisfactory manner.

6. Ensuring compliance with legal requirements: I stayed up-to-date with federal, state, and local laws and regulations related to employee benefits, such as the Affordable Care Act (ACA) and the Employee Retirement Income Security Act (ERISA). I ensured that our benefits programs and processes were compliant with these regulations and made any necessary adjustments or updates as required. 7. Maintaining confidentiality and data integrity: I handled sensitive employee information with the utmost confidentiality and ensured the integrity and security of benefits-related data. I adhered to privacy regulations and company policies to protect employee privacy and maintain compliance. Payroll and Bookkeeping

Hamrick's - Matthews, NC

January 2000 to December 2008

- Processed payroll for a team of 50+ employees using ADP software, ensuring accurate and timely payments.

- Managed accounts payable and accounts receivable, maintaining financial stability and strong vendor relationships.

- Reconciled bank statements and prepared financial reports for management, providing accurate and insightful financial information.

- Maintained accurate records of financial transactions and ensured compliance with accounting standards and regulations, promoting financial integrity. Education

Associate's degree in Accounting

Southern New Hampshire University

December 2022 to Present

Skills

• - Office Management

• Detail-oriented organizer

• Bookkeeping

• Good with information and new data

• Results-driven coach

• Sharp and fast learner

• Certified in Life Coach, Reiki, and Past Life Regression

• Financial report writing

• Accounting

• Accounts Receivable

• Motivational speaker

• Collaborative team player

• Accounts Payable

• QuickBooks

• Data entry

• Journal Entries

• Experienced in remote work

• Bank Reconciliation

• Payroll management

• Empathetic listener

• Personal assistant experience

• Google Docs

• QuickBooks

• Social media management

• Bookkeeping

• CRM software

• SharePoint

• Marketing

• Typing

• Market research

• Google AdWords

• Google Ads

• Accounts payable

• Customer service

• Payroll

• Accounts receivable

• Microsoft Access

• Office management

• Windows

• Accounting

• Experience working with students

• Bookkeeping

• QuickBooks

• Accounts payable

• Accounts receivable

• Accounting

• Payroll

• Office management

• Personal assistant experience

• Typing

• Cash handling

• Customer service

• Microsoft Access

• DocuSign

• Email Marketing

• HIPAA

• CRM software

• Account reconciliation

• Customer relationship management

• Sales

• Analysis skills

• SharePoint

• Market research

• Windows

• Email marketing

• Social media management

• Yardi

• Communication skills

• Time management

• Adobe Creative Suite

• Classroom management

• Team management

• Experience working with students

• Inside sales

• Telemarketing

• Leadership

• Lead generation

• Negotiation

• Business development

• Writing skills

• English

• Microsoft Office

• Organizational skills

• Financial services

• Financial planning

• Administrative experience

• Public accounting

• Search engines

Certifications and Licenses

AED Certification

CPR Certification

Assessments

Customer focus & orientation — Proficient

August 2022

Responding to customer situations with sensitivity Full results: Proficient

Outside sales — Proficient

December 2022

Understanding and responding appropriately in sales scenarios, and performing common sales calculations

Full results: Proficient

Sales skills — Proficient

August 2022

Influencing and negotiating with customers

Full results: Proficient

Customer service — Proficient

December 2022

Identifying and resolving common customer issues

Full results: Proficient

Recruiting — Proficient

September 2023

Managing the candidate sourcing and selection process Full results: Proficient

Attention to detail — Proficient

April 2024

Identifying differences in materials, following instructions, and detecting details among distracting information

Full results: Proficient

Work style: Reliability — Proficient

April 2024

Tendency to be reliable, dependable, and accountable at work Full results: Proficient

Demonstrating empathy — Proficient

April 2024

Demonstrating awareness of others' needs and perspectives Full results: Proficient

Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.



Contact this candidate