Krystal Tanksley

I’m a claims adjudicator and insurance verification professional with 10 years of healthcare experience, and I focus on making sure every decision is accurate, documented, and compliant. In my recent roles, I’ve analyzed and evaluated claims using proprietary systems, payment documentation, and state fee schedules to confirm provider reimbursement.

At CareSource, I reviewed and processed appeals and disputes, assessed supporting documentation, and corrected codes to drive accurate payment disbursements. I also communicated with providers and members to clarify appeal outcomes, explain coverage options, and maintain clear records of adjudication decisions—so everyone understands what’s been decided and why.

Across my work with CareSource, United Healthcare, and healthcare operations, I’ve strengthened my dispute resolution and documentation skills—researching and acquiring needed medical records, conducting timely telephone follow-up to ensure submissions are received, and preparing correct initial bill packets or appeal letters using EC and HER (Epic) tools. I’m at my best when I can combine precise review with patient- and provider-centered communication to resolve claims efficiently.