Skills
Claims Adjudication & Verification
5-10 Years
Quality Assurance & Process Improvement
1-2 Years
Experience highlights
Contract Drafting Analyst
Accenture, Inc.
·
June/2021
–
Present
Skilled in drafting and editing client-facing legal documents that comply with product mandates and healthcare guidelines, ensuring accuracy and customer readiness while collaborating with teams to update content promptly based on client elections.
Trainer & Quality Assurance
Accenture, Inc.
·
June/2017
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Present
Experienced as a Trainer and Quality Assurance Analyst for the Medical Records Support Team, setting process standards, mentoring new hires, identifying compliance gaps, and providing ongoing feedback to improve claim accuracy and efficiency.
Transaction Processing Analyst
Accenture, Inc.
·
September/2012
–
Present
Processed medical insurance claims using the FACETS system, carefully verifying that each claim adhered to applicable benefits, provider contracts, and coding guidelines. Managed and resolved various types of pends—including missing information, eligibility issues, authorizations, duplicates, and corrections—to maintain smooth claim flow and prevent processing delays. Conducted thorough reviews of policy and benefit details to ensure services were covered and claims were accurately processed acc
