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kennesha willis

@kenneshawillis

Medical Claims Examiner at First Source, adjudicating complex claims with 98% administrative and 99% financial accuracy.

United States

Message

At First Source, I independently adjudicate complex medical claims across Medicare, Medicaid, and commercial plans. I process 300 claims per day and maintain 98% administrative accuracy and 99% financial accuracy.

I use QNXT, Claims Viewer, Molina workflow systems, and Availity to review claims, resolve denials and payment discrepancies, and comply with payer and regulatory guidelines. I also investigate coordination-of-benefits issues and overpayments or underpayments.

Previously, I processed medical claims at Accenture and supported claim resolutions, escalated customer inquiries, and identified potential fraud, waste, and abuse. I also served as an administrative assistant at Walker Enterprises, supporting executives and streamlining expense reporting and invoice reconciliation.

Experience

Work history, roles, and key accomplishments

Current

Medical Claims Examiner

Current

First Source

Mar 2022 - Present (4 years 7 months)

Independently manage end-to-end adjudication of complex medical claims in a high-volume, metrics-driven environment, consistently exceeding productivity and accuracy standards. Analyze claims using QNXT, Claims Viewer, and Molina workflow systems, ensuring strict compliance with payer guidelines and regulations.

QNXT Claim Viewer Molina EDI Availity Medicare Medicaid Commercial Insurance CPT ICD 10 HIPAA Claims Adjudication Coordination Of Benefits Denials Management Quality Assurance Mentorship

Medical Claims Processor

Accenture

May 2019 - Jan 2022 (2 years 8 months)

Managed high-volume medical claims and complex case resolutions in a fast-paced, metrics-driven environment, ensuring timely and accurate processing. Served as a key liaison between insurance providers, patients, and internal teams to resolve claim issues and improve outcomes.

EDI Availity Medical Terminology HIPAA Claims Processing Fraud Waste And Abuse Quality Control Customer Support

Administrative Assistant

Walker Enterprises

Mar 2017 - Apr 2019 (2 years 1 month)

Provided high-level administrative support to executives in a fast-paced environment, managing competing priorities with minimal supervision. Streamlined administrative processes, including expense reporting and invoice reconciliation, improving efficiency and reducing processing delays.

Administrative Support Expense Reporting Invoice Reconciliation Travel Coordination Communication Skills Microsoft Office Time Management