Claims Specialist
Processed cancer claims in PEGA system, meeting daily production goals and 100% quality assurance on audited claims. Outbound calls to clients and providers to request medical documentation necessary to process insurance benefits. Researched manuals and insurance policies. Read and comprehended medical documentation such as operative reports, office notes, and drug administration/prescription, with the ability to determine benefits payable. Decoded billing information using CPT codes. Stayed on top of emails, and completed additional tasks requested by management. Followed HIPPA guidelines.