Jamie Redlinger

***** ******* **

Indian Trail, NC 28079

704-***-****

aczw3d@r.postjobfree.com

Summary

Seasoned healthcare professional with thorough industry knowledge across various operational positions.

Core Qualifications

• Over 20 years of Healthcare experience

• Superior knowledge of claims analysis to include ICD10, CPT, HCPCS, and medical terminology

• Complete understanding of healthcare plan design and benefits

• Consistently in top margin for quality

• Strong customer service and problem solving skills

• Able to work both individually and within a team setting with minimal supervision

• High time management and organizational abilities

• Good verbal and written communication skills

• Strong knowledge of Microsoft Office suite and claim adjudication systems Career Experience

Claims Auditor 2012-2017

Key Benefit Administrators Fort Mill, SC

• Performed audits on medical, dental, and vision claims.

• Resolved errors by communicating with Claims Manager or Supervisor.

• Performed audits on eligibility and plan building setup.

• Maintained procedural and financial quality on various departments.

• Adjusted claims for appeals and reviews.

• Ensured compliance with health plan requirements Client Rep/Claims Analyst 2011-2012

Medicompanies Matthews,NC

• Answered questions and assisted clients with various issues either directly or through one of the senior client managers.

• Interacted daily with clients, vendors, client managers, and operational staff to ensure successful customer service satisfaction.

• Handled inbound and outbound calls from Key Account customers performing a high level of communication and follow up.

• Maintained a growing knowledge of the ever changing healthcare laws to manage clients and optimize their business.

Prior Healthcare Experience

BMS, The Wellness Plan, United Healthcare 1997-2011 Customer Service, Claims Analyst

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