Detail-oriented Encounter Data Analyst. Exceptional analytical skills, effective strategic business practices and strong attention to detail. Accustomed to collaborating with team members to review, research and meet a c…
Detail-oriented Encounter Data Analyst. Exceptional analytical skills, effective strategic business practices and strong attention to detail. Accustomed to collaborating with team members to review, research and meet a common goal. Driven by quality, and process improvement.
Research, identify and analyze incorrect Delete Requests from CMS.
Correct any matching records that meet a specific criterion provided as part of the delete transaction.
Apply quality assurance principles to delete requests for final approval to ensure accuracy and process improvement.
Assemble and distribute daily workload RIP report for management.
Deliver and track work assignments for Delete processing team.
Collaborated with team members to create, test, and implement SOPs for different areas of the Delete processing department.
Analyst. Customer support. Error Reports. SOPs and Job AIDS. CMS delete processing. Reconciliation. Accumulator Implementation. Data processing. Training, mentoring. Running Reports for management. Working and collaborating with team members.
Verified failed pharmacy transactions for carve in and carve out vendor Error Reports.
Researched and verified member’s eligibility details for accuracy and validation.
Updated spreadsheets and implemented pivot tables for accurate data.
Provided claims support in reviewing, researching, investigating, negotiating, processing, and adjusting claims.
Initiated and analyzed manual claim workups to identify if RX refunds were warranted.
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