Jabrina Taylor
Nashville
Summary
Diligent Claims Processor versed in insurance processes and claims procedures. Offers great attention to detail and time management abilities to successfully handle large volume of claims. Highly accurate and thorough with focus on completing error-free work in line with processing guidelines. 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.
Overview
14
14
years of professional experience
Work History
Claims Processor
Cigna
02.2023 - Current
- Enhanced claim processing efficiency by implementing new software and streamlining procedures.
- Reduced claim processing time for faster customer service and improved satisfaction rates.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Identified fraudulent claims through thorough investigation and documentation of findings.
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Trained new employees on claims processing procedures, contributing to a well-prepared workforce.
Patient Account Representative
MedCycle Management
01.2022 - 02.2023
- Initiates proactive measures that result in account resolution
- Responds timely and accurately to all incoming correspondence and inquiries from insurance companies, and other appropriate parties
- Initiates contact with patient, as necessary
- Initiates recommendations and action plans for resolving accounts
- Responds to all phone calls in an efficient and courteous manner
- Documents appropriate notes in system for every account, including any action taken
- Appropriate follow up and systems processes following MedCycle guidelines
- Review EOB's to ensure that appropriate steps are taken in resolving accounts.
Billing Specialist/ Payment Poster
Community Health Systems
01.2017 - 01.2022
- Identify and analyze trends with payers to ensure correct payments are applied
- Analyze accounts for balance and billing accuracy, collections, insurance requests, denials
- Post payment and adjustments to patient's accounts and statements from all insurance payers
- Corrected discrepancies as needed.
Billing Specialist
CGS Administrators
01.2015 - 01.2017
- Collecting, posting, and managing account payments
- Prepare and submit clean claims to various insurance companies by electronic or by paper
- Follow up with insurance companies
- Identifies and resolves patient billing complaints
- Evaluates patient's financial status and establishes budget payment plans
- Prepares, reviews and sends patient statements
- Answering telephone calls and dealing with face-to-face inquiries; scheduling appointments
- Insurance claims processor
- Gather and review denied claims appeals, appeals request letters and medical documentation for Medicare/Medicaid and Commercial insurance/ Third Party billers
- Examining medical records and claims information for first level appeal cases to determine whether services provided were medically necessary or meet Medicare coverage guidelines in accordance with Medicare regulations and policies.
HR Assistant
Amazon
01.2014 - 01.2015
- Administering tests, scheduling appointments, conducting orientation, while maintaining records and information
- Compiling and updating employee records
- Coordinate HR projects, meetings, training and surveys
- Coordinate communication with candidates and scheduling interviews
- Assist our recruiters to source candidates and update our database.
Assembly Tech
Unipres
01.2012 - 01.2014
- Assemble operations on components
- Conduct quality control checks
- Assist in the development of manufacturing procedure to create the most efficient process
- Monitoring equipment performance while making minor/routine adjustments
- Performing routine repairs and inspections on equipment.
Quality Assurance
Sara Lee
01.2010 - 01.2012
- Making sure that all employees comply with all policies regarding company and OSHA guidelines
- Inspecting all equipment before start up to ensure that everything was in good standards to run production
- Inspecting product to make sure that everything was the right temperature, weight size and more
- Document internal audits and other quality assurance activities
- Identify training needs and organize training interventions to meet quality standards.
Education
Associate Degree: Business -
Nashville State Community College
01.2015
Certification: Medical Assistant -
Remington College
01.2011
High School Diploma -
Cape Central High School
01.2010
Skills
- Problem Solving and critical thinking
- Professionalism and strong work ethic
- Excellent communication skills
- Initiative and drive
- Proficient in Microsoft Office
- New Leaf
- Kronos
Timeline
Claims Processor
Cigna
02.2023 - Current
Patient Account Representative
MedCycle Management
01.2022 - 02.2023
Billing Specialist/ Payment Poster
Community Health Systems
01.2017 - 01.2022
Billing Specialist
CGS Administrators
01.2015 - 01.2017
HR Assistant
Amazon
01.2014 - 01.2015
Assembly Tech
Unipres
01.2012 - 01.2014
Quality Assurance
Sara Lee
01.2010 - 01.2012
Associate Degree: Business -
Nashville State Community College
Certification: Medical Assistant -
Remington College
High School Diploma -
Cape Central High School
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