Review Analyst
Current■ Reviewing and analyzing health insurance claims, with expertise in initiating and following up on appeals for commercial payors, Medicaid, Tricare, the VA, and Workman's Compensation. ■ Handling authorizations, ensuring timely approvals, and coordinating with healthcare providers for necessary billing. Strong training and customer service background, adept at aiding both internal teams and external customers. ■ Excellent analytical skills identifying discrepancies to ensure accurate… Show more ■ Reviewing and analyzing health insurance claims, with expertise in initiating and following up on appeals for commercial payors, Medicaid, Tricare, the VA, and Workman's Compensation. ■ Handling authorizations, ensuring timely approvals, and coordinating with healthcare providers for necessary billing. Strong training and customer service background, adept at aiding both internal teams and external customers. ■ Excellent analytical skills identifying discrepancies to ensure accurate processing and minimize errors. ■ Skilled in process improvement, identifying areas for optimization and implementing strategies to enhance overall efficiency. ■ Focus groups to gather feedback on claims processes, identifying opportunities for improvement and implementing strategies to enhance efficiency and accuracy. ■ Develop and deliver training programs for internal teams on claims processing, appeals, authorizations, and customer service. ■ Collaborate with cross-functional teams to streamline processes, enhance communication, and achieve organizational goals. ■ Actively participate in process improvement initiatives, suggesting and implementing strategies to optimize claims operations and reduce turnaround times. Show less