Makayla Golston
Columbia
Summary
Detail-oriented Claims Processor with over 4 years of experience in reviewing and processing insurance claims, ensuring accuracy and adherence to policy guidelines. Proven ability to verify claim information, communicate effectively with clients and healthcare providers, and identify potential fraud cases, resulting in increased operational efciency. Expertise in documentation accuracy and data entry, handling up to 40 claims daily while maintaining a meticulous record-keeping system. Committed to enhancing customer satisfaction and streamlining processes, delivering exceptional value to the organization.
Overview
7
7
years of professional experience
Work History
Health Information Specialist I.
Pruitt Health
02.2023 - Current
- RECEIVE AND PROCESS REQUESTS FOR PATIENT HEALTH INFORMATION
- MAINTAIN CONFIDENTIALITY AND SECURITY WITH ALL PRIVILEGED INFORMATION
- MAINTAIN WORKING KNOWLEDGE OF COMPANY AND FACILITY SOFTWARE
- ADHERE TO THE COMPANY'S AND CUSTOMER FACILITIES CODE OF CONDUCT AND POLICIES
- MANAGING PATIENT HEALTH RECORDS
- RESPONSIBLE FOR SAFEGUARDING PATIENT RECORDS AND ENSURING COMPLIANCE WITH HIPAA STANDARDS
- PREPARES NEW PATIENT CHARTS, GATHERING DOCUMENTS AND INFORMATION FROM PAPER SOURCES AND/OR ELECTRONIC HEALTH RECORD
- Collaborated with healthcare providers to facilitate seamless communication regarding patient data and information management.
Chat Supportive Representative
Palmetto State Armory
05.2019 - 02.2023
- Provided real-time support to customers through live chat channels, addressing inquiries, and resolving issues.
- Delivered accurate information about products, services, and company policies, maintaining a professional tone.
- Handled up to 40 chat interactions per day, balancing multiple chats and prioritizing urgent requests.
- Documented customer interactions, tracked issues, and updated records in the CRM system.
Claims Processor
Call 4 Health
08.2018 - 04.2019
- Reviewed and processed insurance claims, ensuring accuracy and adherence to policy guidelines.
- Verified claim information, including documentation, and calculated claim amounts.
- Communicated with clients, healthcare providers, and agents to gather information and resolve issues.
- Maintained accurate records of claims, updated claim statuses, and identified potential fraud cases.
Education
High School Diploma -
Penn Foster
01.2023
Skills
- Insurance Verification Proficient
- Remote work capabilities Proficient
- Attention to Detail Expert
- Documentation Accuracy Expert
- Time Management Expert
- Data Entry Expert
- Office administration Advanced
- Customer service Expert
Timeline
Health Information Specialist I.
Pruitt Health
02.2023 - Current
Chat Supportive Representative
Palmetto State Armory
05.2019 - 02.2023
Claims Processor
Call 4 Health
08.2018 - 04.2019
High School Diploma -
Penn Foster