Trateika Robinson
Portsmouth
Summary
Experienced with processing diverse insurance claims and ensuring compliance with regulatory standards. Utilizes attention to detail and analytical skills to identify discrepancies and expedite resolutions. Track record of maintaining accurate records and delivering exceptional customer service.
Overview
9
9
years of professional experience
Work History
Claims Processor II
Elevance Health
04.2021 - Current
- Reviewing and evaluating claims for accuracy, completeness, and compliance with company policies and regulations.
- Analyzing claims to determine eligibility, coverage, and potential issues, such as discrepancies or denials.
- Calculating and applying benefit information to claims ensuring accurate payments.
- Communicating with members, providers, and other stakeholders to address inquiries and resolve issues.
- Maintain 98% accuracy rate while ensuring compliance with HIPAA and company standards.
- Train new hires on internal systems and claims workflow.
Claims Processor
WPS
03.2020 - 04.2021
- Supported clients with filing appeals and adjustments on claims that were denied or partially paid.
- Reviewed and effectively processed claims for Tricare in a prompt manner.
- Researched various databases to ensure accurate client information for ease of claim processing.
- Processed 200+ claims daily to exceed productivity expectations.
Eligibility Specialist
Maximus
03.2018 - 03.2020
- Reviewed applicants for various programs to determine if they meet the necessary qualifications.
- Worked collaboratively with several government aid agencies in the healthcare industry such as Medicare and Medicaid in order to process disability claims.
- Served as subject matter expert while answering internal and external questions regarding the application process and financial assistance.
- Prepared and maintained client files while having a strong knowledge of basic terminology to better understand the services and procedures.
Sales Associate
Dillards Department Store
07.2016 - 04.2018
- Maintained records related to sales, returns and inventory availability.
- Implemented up-selling strategies such as recommending accessories and complementary purchases to boost revenue.
- Educated customers on promotions to enhance sales while maintaining top-notch client service standards and overall satisfaction.
- Reconciled cash drawer at the start and end of each shift, accounting for errors and resolving discrepancies.
Education
High School Diploma -
Heritage High School
Newport News, VA06-2003
Skills
- Data entry proficiency
- Transactions reconciliation
- Medical terminology
- Claims processing
- Critical evaluation
- Accuracy and precision
Timeline
Claims Processor II
Elevance Health
04.2021 - Current
Claims Processor
WPS
03.2020 - 04.2021
Eligibility Specialist
Maximus
03.2018 - 03.2020
Sales Associate
Dillards Department Store
07.2016 - 04.2018
High School Diploma -
Heritage High School
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