Kristin Kosterman Email & Phone Number

Eau Claire, Wisconsin, United States

United States

Eau Claire, Wisconsin Area

• Reviewed medical insurance claims and checked new claims for various items, including whether the procedure is medically necessary and whether the insurance policy covers the procedure.
• Checked claim status of claims and reported back to customer with an update on claim
• Adjusted claims if claims were paid or denied incorrectly
• Sent letters to providers and members regarding claims that were paid incorrectly

Eau Claire, Wisconsin Area

• Communicated and collaborated with members to resolve claim errors/issues
• Completed on a daily basis all data entry required to document and communicate the status of claims as needed, adhering to all reporting requirements
• Acquired knowledge of medical coding
• Reviewed and researched assigned claims by navigating multiple computer systems and platforms
• Accurately captured the data/information necessary for processing (e.g. verified pricing, prior authorizations, applicable benefits)
• Ensured that the proper benefits were applied to each claim by using the appropriate process and procedures (e.g. claims processing policies and procedures, grievance procedures, Medicare guidelines, benefit plan.

Eau Claire, Wisconsin Area

• Worked in many different locations to fix claim that were processed incorrectly from field service.
• Understood provider contracts, procedural contracts, procedural documentation, plan benefits and Medicare regulations.
• Conducted a thorough analysis of all tasks handled by the processing team
• Learned strong writing ability to facilitate documentation of audits
• Understood all aspects of claims processing, including but not limited to workflow pends, complex claim topics and adjustments.
• Responsible for auditing all claim types and tasks assigned from different groups such as Medicare and Medicaid.

Eau Claire, Wisconsin Area

• Loaded/Unloaded semis full of merchandise
• Distributed merchandise within the warehouse
• Checked in trucks