Linaja Kinsey
@linajakinsey
Claims analyst specializing in accurate medical claims adjudication, denial management, and process improvement.
United StatesWhat I'm looking for
I’m a claims professional who adjudicates and resolves complex medical claims across commercial, Medicare, and Medicaid plans, applying plan documents, contractual terms, and regulatory requirements to drive accurate outcomes.
I own end-to-end claims review—from eligibility verification and benefits interpretation to coding validation (CPT/HCPCS/ICD-10), claim edits, pricing, coordination of benefits, provider disputes, and denial management—while strengthening controls and reducing errors and processing delays through continuous process improvement.
In my most recent roles, I investigated pricing, reimbursement, and benefit configuration issues, resolved 400–600 claim discrepancies per month, and improved turnaround time by 20% through structured analysis and recurring reporting. I also analyzed denial trends and claim edit behavior, reducing avoidable denials by 18% via workflow changes and updated processing guidance.
I combine data-driven problem-solving with high-quality execution: I’ve sustained strong accuracy and metric attainment, protected data integrity by monitoring and reconciling system activity, and supported audit readiness through targeted audits, claim sampling, and test plan execution.
Experience
Work history, roles, and key accomplishments
Verify sensitive patient information and documentation with high attention to detail, maintaining accurate electronic records and meeting daily deadlines. Review discrepancies, collaborate across departments to resolve issues, and maintain strict PHI confidentiality.
Claims Analyst
Women's Care
Aug 2025 - Jan 2026 (5 months)
Investigated pricing and reimbursement/benefit configuration issues, resolving 400–600 claim discrepancies per month and improving turnaround time by 20%. Analyzed denial trends and claim edits to cut avoidable denials by 18%, improved productivity by 12% while sustaining 97%+ quality, and prevented an estimated $150K in potential incorrect payments per quarter.
Lab Specimen Processor
Unified Women's Healthcare
May 2024 - Aug 2025 (1 year 3 months)
Processed incoming lab specimens by verifying documentation accuracy, resolving discrepancies, and ensuring compliance with required standards. Managed high-volume workflows and coordinated with healthcare professionals to resolve documentation issues while maintaining confidentiality and data integrity.
Processed 1,200+ medical claims/adjustments monthly with 98% accuracy, verifying eligibility, benefits, and coordination of benefits to reduce provider follow-ups by 15%. Managed denials and reprocessing to improve resolution rates by 20%, delivered 4.7/5 customer satisfaction, and contributed to SOP updates that cut onboarding ramp time by 25%.
Medical Claims Processor
Beyond Finance
May 2022 - Jun 2023 (1 year 1 month)
Reviewed and processed high-volume medical claims, verifying information and resolving documentation discrepancies with strict attention to detail. Maintained confidential records in compliance with privacy regulations and ensured timely, accurate data entry to support claims resolution.
Education
Degrees, certifications, and relevant coursework
Hillsborough High School
High School Diploma, High School
2018 - 2022
Completed a high school diploma at Hillsborough High School from August 2018 to May 2022.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Job categories
Skills
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