Kate Knedler
Beckenham ,WA
Summary
I have worked in health insurance for the last 9 years and am ready to make a change in my career. I have spent a lot of time in administration but I have traveled a lot in my early 20s and that has given me a lot of interactions with different cultures and types of people. That and working with people gives me broad experience with customer facing and quality assurance.
Overview
8
8
years of professional experience
Work History
Claims Processing Clerk
HBF Health Fund
10.2015 - 06.2023
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Managed workload and priorities to meet claims processing meet deadlines.
- Calculated adjustments, premiums and refunds.
- Checked documentation for accuracy and validity on updated systems.
- Demonstrated excellent problem-solving skills by identifying potential issues early on during the claims process and addressing them proactively.
- Enhanced claims processing efficiency by streamlining workflows and implementing organizational systems.
- Assisted in onboarding of new claims processors to familiarize with company procedures, policies and processes.
- Posted payments to accounts and maintained records.
- Streamlined communication channels between departments, fostering improved collaboration and expediting claim resolutions.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Handled high volume of daily claims while consistently meeting deadlines and maintaining attention to detail.
- Communicated effectively with staff members of operations, finance and clinical departments.
- Achieved high levels of accuracy and consistency in claims processing through diligent attention to detail and a commitment to continuous improvement.
- Adapted quickly to changes in company policy or industry regulations, ensuring continuous high-quality performance as a Claims Processing Clerk.
- Reviewed outstanding requests and redirected workloads to complete projects on time.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Expedited claim resolution times with thorough investigation and timely communication with involved parties.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Monitored claims processing trends to identify potential areas of improvement.
- Contributed to a positive work environment by sharing best practices and supporting colleagues in their tasks when needed.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Reduced claim errors by meticulously reviewing and validating documentation before submission.
- Assisted in training new hires on company policies, procedures, and software tools for effective claims handling.
- Developed and implemented quality assurance processes to check accuracy of claims processing.
- Generated, posted and attached information to claim files.
- Maintained confidentiality of patient finances, records, and health statuses.
- Collaborated with team members to identify and address areas of improvement in the claims process, resulting in overall efficiency gains.
- Verified client information by analyzing existing evidence on file.
- Maintained up-to-date knowledge of industry regulations, ensuring compliance in all aspects of claims processing.
- Actively participated in team meetings and training sessions, contributing valuable insights and staying current on best practices in the industry.
- Organized and maintained comprehensive electronic filing systems for efficient retrieval of claim-related documents.
- Utilized specialized software to process incoming claims, enter data and generate reports.
- Tracked and reported on claims processing metrics to aid senior management in making informed decisions.
- Utilized excellent analytical and problem-solving skills to quickly and accurately assess insurance claims.
- Managed sensitive customer data securely, adhering to strict privacy guidelines and protecting client information from potential breaches.
- Complied with regulations and guidelines related to claims processing to maintain quality and adherence to standards.
- Passionate about learning and committed to continual improvement.
- Learned and adapted quickly to new technology and software applications.
- Strengthened communication skills through regular interactions with others.
- Completed paperwork, recognizing discrepancies and promptly addressing for resolution.
- Excellent communication skills, both verbal and written.
Education
Year 12 - High Schol
St Stephens
Duncraig, WA10.2005
Skills
- Documentation abilities
- Policy Review
- Reporting skills
- Teamwork and Collaboration
- Medical terminology knowledge
- Account Management
- Data Entry
- Organizing and Prioritizing Work
- Medical Terminology
- Insurance Regulations Understanding
Timeline
Claims Processing Clerk
HBF Health Fund
10.2015 - 06.2023
Year 12 - High Schol
St Stephens
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