Carmina Priol
@carminapriol
Experienced claims specialist with strong analytical and problem-solving skills.
What I'm looking for
I am a dedicated claims specialist with over three years of experience in the healthcare industry, specializing in medical claims processing and customer service. My journey began at Conduent, where I honed my skills in handling medical claims, effectively communicating with healthcare providers, and addressing their inquiries regarding claim processes. My attention to detail and strong organizational skills allowed me to excel in this role, ultimately earning recognition as the top agent for my performance.
Currently, I serve as a team leader at Ista Solutions, where I oversee a medical billing account. My responsibilities include submitting claims, resolving discrepancies, and ensuring accurate payment posting. I take pride in my ability to lead a team and maintain high standards of service, which has resulted in significant incentives from clients for our excellent performance. I am passionate about continuous improvement and strive to enhance the efficiency of our processes.
Experience
Work history, roles, and key accomplishments
Team Leader in Medical Billing
Ista Solutions
Jan 2022 - Present (3 years 6 months)
Led a team in a Medical Billing account, responsible for submitting and fixing rejected claims, monitoring claim statuses, and following up on unpaid or denied claims. Managed payment posting from various insurances and ensured accurate system entry, along with encoding PDPM scores and diagnoses.
Claim Specialist
Conduent
Sep 2018 - Present (6 years 10 months)
Handled medical claims and responded to healthcare providers to explain claim processes, status, and address various questions and concerns related to their claims. This role involved communication via phone calls and emails.
Education
Degrees, certifications, and relevant coursework
Caramoan Community College
Bachelor of Elementary Education, Elementary Education
Grade: 1.59
Graduated with Academic Distinction, achieving a General Weighted Average (GWA) of 1.59. The program provided a comprehensive understanding of elementary education principles and practices.
Availability
Location
Authorized to work in
Job categories
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