LaKrisha Goins

I’m a Claims Adjudicator and Claims Processor with 12+ years of experience reviewing and resolving complex medical and disability claims in a high-volume environment. I interpret physician records, specialist reports, diagnostic results, and treatment histories to make accurate, well-supported decisions.

I’m known for catching what others miss—documentation gaps, unsupported findings, and inconsistent medical evidence—and resolving issues efficiently before closing a case. I evaluate claimant-reported symptoms against objective medical findings and apply functional assessment criteria across a wide range of conditions.

At the Social Security Administration, I collaborated with medical reviewers and clinical consultants on complex or borderline cases, then produced thorough written determinations that clearly explained the medical rationale for claimants, reviewers, and appeal examiners. I’ve consistently managed a remote caseload while meeting production and accuracy targets.

In addition to adjudication, I handled the full claims workflow: intake, data entry into claims management systems, requesting missing medical records, verifying claimant information, and correcting billing or coding issues. I also supported appeals and reconsiderations, reviewed additional evidence, and trained new team members on intake procedures, medical record review, and quality standards.