McKenzie Young
@mckenzieyoung
Highly motivated Claims Specialist in insurance, blending claims processing, customer service, and data analysis.
What I'm looking for
I am a highly motivated Claims Specialist with a track record in the insurance industry, skilled in claims processing, customer service, and data analysis. I focus on accuracy, follow-through, and clear communication to move claims and authorizations forward.
In my UM Coordinator role, I handled appeals, denial letters, authorizations, and clinicals. I also completed document work such as attaching files and faxing them to facilities to support timely decision-making.
As a Medical Claims Processor, I processed medical claims across categories including radiology, ambulance, hospital, and SNF. I worked through payments, authorization creation and denials, medical claim adjusting, and coding.
Earlier, I supported members and claims through Medical Billing Processor work and a Customer Service Representative role. I processed billing adjustments, handled inbound calls with HCPS regarding member bills with BCBS, and managed customer interactions related to reimbursement checks while maintaining accountability and attention to detail.
Experience
Work history, roles, and key accomplishments
Coordinated utilization management tasks including handling appeals and denial letters, managing authorizations, and submitting clinical documentation. Attached files and faxed materials to facilities for processing.
Medical Claims Processor
Wipro Health Plan Services
Mar 2020 - May 2026 (6 years 2 months)
Processed medical claims for radiology, ambulance, hospital, and SNF services, including payment processing. Created and denied authorizations, performed medical claims adjusting, and worked with coding.
Medical Billing Processor
Wipro Health Plan Services
May 2019 - Feb 2020 (9 months)
Processed and adjusted medical billing, including handling manual files. Took inbound calls with healthcare providers to address member billing inquiries.
Handled inbound and outbound calls and was accountable for issuing reimbursement checks to customers due to a payment error. Supported customer service activities related to reimbursement processing.
Education
Degrees, certifications, and relevant coursework
Freedom High School
High school or equivalent, Business
2014 - 2018
Completed a high school education with a business focus at Freedom High School in Tampa, FL from 2014 to 2018.
Tech stack
Software and tools used professionally
Availability
Location
Authorized to work in
Job categories
Skills
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