PATRICIA WHALEY

NASHVILLE, TN *****

615-***-****

ad2so2@r.postjobfree.com

Professional Summary

Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.

Skills

CLAIM PROCERSSING

Troubleshooting Skills

Database Tracking

Client Relations

DATA ENTRY

COMMUNICATION

ESCALATIONS

NEGOTIATION

MICROSOFT OFFICE

EXCELL

Work History

July 2020 - August 2023

PATHGROUP NASHVILLE,TN - NASHVILLE,TN

EDIT ANALYST

MAINTAIN UPDATED RECORDS AND PREPARES FOR REQUIRED DOCUMENTATION.

REVIEWS CLAIMS FOR ELIGIBILITY TO BE REIMBURSED.

ANALYZES AND REVIEWS INSURANCE CLAIMS FOR ACCURACY, COMPLETENESS,AND ELIGIBLILITY.

ESCALATIONS CALLS IF NEEDED FOR NEGOATATION OF CONTRACTS.

January 2020 - May 2020

DAVITA DIALYSIS CLINIC - BRENTWOOD,TN

BILLING CHARGE MASTER

ANALYZES AND REVIEWS INSURANCE CLAIMS FOR ACCURACY,COMPLETENESS,AND ELIGIBILITY.

REVIEWS CLAIMS FOR ELIGIBILITY TOF BE REIMBURSED.

MAINTAINS UPDATED RECORDS AND PREPARES REQUIRED DOCUMENTATION.

ASSISTS IN CONTROLLING THE COST OF PROCERSSING CLAIMS.

CONTACTS POLICYHOLDERS ABOUT CLAIMS AND MAY PROVIDE INFORMATION REGARDING THE AMOUNT OF BENEFITS.

January 2019 - December 2019

EVICORE HEALTHCARE - FRANKLIN,TN

CLAIMS ANALYST

Maintained strict confidentiality with all personal data as per company guidelines.

Identified insurance coverage limitations with thorough examinations of claims documentation and related records.

Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.

Reviewed and analyzed suspicious and potentially fraudulent insurance claims.

June 2010 - August 2018

DXC Technology, Hewlett Packard Enterprise - Nashville, TN

Claims Review Analyst

Conducted day-to-day administrative tasks to maintain information files and process paperwork.

Identified insurance coverage limitations with thorough examinations of claims documentation and related records.

Researched claims and incident information to deliver solutions and resolve problems.

Reviewed and analyzed suspicious and potentially fraudulent insurance claims.

Education

August 2000

Aquinas College Nashville, TN

No Degree Business Administration And Management

May 1985

George Washington Carver High School Memphis, TN

High School Diploma

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