Amber Adams
Dillon,SC
Summary
Professional Claims Specialist with hands-on experience in managing claims processes efficiently. Skilled in evaluating and processing claims, ensuring compliance with regulations, and maintaining high standards of accuracy. Strong focus on teamwork and delivering results in dynamic environments. Reliable and adaptable, excelling in customer service and problem-solving.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Claims Representative Associate
EviCore by Evernorth
Remote
07.2022 - Current
- Processes medical claims with attention to detail, verifying accuracy of claim data and compliance with policies.
- Assists in confirming insurance eligibility and prior authorizations as needed.
- Achieves departmental quality standards and production goals.
- Maintains organized records and completes administrative tasks related to claim processing using various software and spreadsheets.
Billing Specialist
McLeod Health
Dillon, SC
11.2019 - 07.2022
- Reviewed claims to verify accurate ICD-10 codes and charges prior to submission to insurance for payment for McLeod Pediatrics Dillon and McLeod OB/GYN Dillon.
- Assisted in maintaining proper clinical documentation and capturing preventative services such as screenings and immunizations for all patient visits.
- Collected and posted patient payments and processed refunds to patients and insurance companies.
- Evaluated delinquent accounts for collection efforts.
Clerical Associate
McLeod Health
Dillon, SC
08.2017 - 07.2022
- Managed patient check-in and check-out processes to enhance operational efficiency.
- Oversaw verification of patient demographics and insurance eligibility.
- Coordinated collection of copayments and addressed telephone inquiries.
- Handled medical record requests from various entities and prepared necessary invoices.
- Organized follow-up appointments and referrals to ensure continuity of care.
Certified Medical Assistant
McLeod Health
Dillon, SC
12.2013 - 07.2022
- Triaged patients upon arrival and documented reason for visit.
- Reconciled medications and refill requests.
- Assisted the doctors with office procedures.
- Administered medications and vaccinations as directed by the doctor.
- Collection and analysis for laboratory procedures.
- Provided patient education.
Medical Assistant
Carolina Medical Alliance
Florence, SC
03.2008 - 12.2013
- Triaged patients upon arrival and documented reason for visit.
- Reconciled medications and refill requests.
- Assisted the doctors with office procedures and surgeries. Administered EKGs, medications and vaccinations as directed by the doctor.
- Scheduled testing and referrals.
- Managed medical records requests and invoicing.
Education
Certificate - Medical Billing And Coding
Kaplan University
Davenport, IA04.2017
Certificate - Medical Assisting
Florence-Darlington Technical College
Florence, SC08.2008
High School Diploma -
Avalon Academy
Dillon, SC 05.2001
Skills
- Claims processing
- Multitasking
- Attention to detail
- Documentation research
- Time management
- Computer proficiency
- Medical terminology
- Data entry
Certification
- CCMA - Certified Clinical Medical Assistant
Timeline
Claims Representative Associate
EviCore by Evernorth
07.2022 - Current
Billing Specialist
McLeod Health
11.2019 - 07.2022
Clerical Associate
McLeod Health
08.2017 - 07.2022
Certified Medical Assistant
McLeod Health
12.2013 - 07.2022
Medical Assistant
Carolina Medical Alliance
03.2008 - 12.2013
Certificate - Medical Billing And Coding
Kaplan University
Certificate - Medical Assisting
Florence-Darlington Technical College
High School Diploma -
Avalon Academy