Deborah Harrell

Claims Quality Assurance Manager with 14+ years of expertise in claims adjudication, policy documentation, and medical billing. Proficient in Medicaid, UB04 claims, and insurance claims processing, driving operational efficiency through meticulous audits and targeted training. Committed to enhancing team proficiency and ensuring compliance with industry standards through effective collaboration an

Resolved complex claims and appeals, reducing pend values and ensuring contract compliance. Led cross-departmental initiatives, enhancing claims processing efficiency and reducing inaccuracies. Conducted root cause analysis of claims inaccuracies, implementing corrective actions and identifying trends. Supported team members in understanding new workflows, improving departmental compliance.

Examined and processed claims, ensuring compliance and resolving intricate issues efficiently. Surpassed daily claim production goals by managing audits and special projects effectively. Maintained customer service logs within a 5-day turnaround, enhancing service satisfaction. Collaborated with claimants, providers, and clients to resolve inquiries accurately and compliantly.

Processed supplemental medical claims, ensuring accuracy and compliance with insurance laws. Resolved claim issues promptly, improving customer satisfaction and operational efficiency. Provided expert advice on insurance matters, fostering trust and reliability among stakeholders. Developed new communication strategies, leading to a significant increase in positive feedback.

Processed incoming calls from patients, brokers, and insurance companies, resolving inquiries efficiently. Managed and analyzed reports for timely account handling, boosting workflow efficiency. Handled claims and correspondence follow-up, ensuring accurate and prompt resolution. Maintained and prepared medical records, supporting compliance and operational efficiency. Collaborated on patient paym

Processed over 75 claims daily using AMISYS, ensuring accuracy and compliance with healthcare regulations. Mentored a team of 15-20, serving as a Subject Matter Expert in medical billing and claims adjustments. Resolved complex medical billing issues, achieving a 95% claim approval rate through meticulous review. Facilitated cross-departmental communication to expedite claims resolution, enhancing

Researched and processed claims, ensuring adherence to guidelines and procedures. Trained new hires, reducing onboarding time by 25%. Audited team members' claims, saving the company $50,000 annually. Generated accurate and timely daily reports. Adjusted medical billing and claims as needed. Enhanced claims processing workflow, improving team efficiency by 20%. Led initiatives to reduce claims bac