Experience

Citizant

• United States
• IT Services and IT Consulting
• 100 - 200 Employee

• Credential Specialist

  • Jun 2021 - Present

  • Critical thinking skills to respond to a variety of technical issues from customers via phone, email, web messages, chat, fax, or mail • Proficient in using the NCAMS system, HHS, People Processing System, CWS system • • Office management activities including organizing and upkeep of the office, as well as other office duties which include ensuring shared office equipment and supplies are available and in working order. • Lead as a resource for new hires and assist with new hire fingerprinting, authorize documents, and badge issuance. • Join in team meetings and trainings • Properly document and maintain relevant record systems to meet compliance requirements. • Enroll, issue and activate numerous types of identification cards, including SmartID Cards. • apply suitability factors and security guidelines when making decisions or adverse action recommendations for suitability, physical access, smart card eligibility • Perform certificate rekey, pin reset, and card update activities. • Deescalate customer issues regarding custodian functions and access are made available on the customer’s Smart Card by using conflict management skills. • Proficient in using the NCAMS system, HHS, People Processing System, CWS system • Provide administrative support and serve as a liaison for personnel security, employees, and with hiring manager, and implementing best practices



Kaiser Permanente

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Claims Specialist

  • Aug 2017 - Jun 2021

  • Properly researches and analyzes denial data and coordinates denial recovery responsibilities. • Balances deposits and processes medical financial transactions • Examines, responds, and documents insurer and patient correspondence/inquiry notes regarding coverage, benefits, and reimbursement on patient invoices. • Navigate Epic Financial system to keep documentation of all transactions • Detects, analyzes, validates, and researches frequent root causes of denials and develops corrective action plans for resolution of denials. • Performs retro reviews of denials, submits formal appeal letters and follows up with the payer in proper time frame. • Exhibit excellent time management skills to effectively complete assignments within established time frames, optimize collections, and meet performance goals. • Properly demonstrate knowledge of all equipment and systems/technology necessary to complete duties and responsibilities. • Respond to phone calls, internal questions, and correspondence from various departments, outside agencies, and payers regarding information pertaining the resolution of denied claims. • Research denials included in EOBs for resolution and files appropriately. • Resolve all issues in retrieval of medical records from large facilities • Operated main systems including Foundations, HPCHATS, ACI, SLP, and EPIC