Rhomalyn Loren

Performed accurate data and charge entry based on clinical documentation, verifying patient demographic and insurance information prior to claim submission. Prepared and submitted clean claims electronically or via paper to insurance payers, ensuring all services were coded correctly. Posted payments from insurance and patients, including adjustments and refunds, and monitored unpaid or denied cla

Performed accurate data and charge entry based on clinical documentation, verifying patient demographic and insurance information prior to claim submission. Prepared and submitted clean claims electronically or via paper to insurance payers, ensuring all services were coded correctly using CPT, ICD-10, and HCPCS codes. Posted payments from insurance and patients, including adjustments and refunds,

Posted daily payments from various sources including electronic funds transfer (EFT), checks, cash, and credit card transactions, matching payments to appropriate patient accounts and invoices. Processed contractual adjustments, write-offs, and account corrections in accordance with payer agreements. Identified and resolved posting discrepancies such as short payments, overpayments, or denials.

Processed and submitted insurance claims accurately and in a timely manner, billing claims to the correct payer based on insurance eligibility and plan details. Posted payments from insurance companies and patients, reviewing Explanation of Benefits (EOBs) to ensure correct posting and identify underpayments or denials. Conducted follow-ups on unpaid or denied claims and initiated appropriate acti

Accurately processed healthcare claims for providers and members in IL, OK, and TX, in accordance with payer-specific rules and federal/state regulations. Analyzed claim data to identify discrepancies, errors, or missing information, taking corrective actions when necessary. Performed audits on processed claims to ensure data accuracy and compliance with established policies.

Studied foundational principles and practices of elementary education, covering various subjects and teaching methodologies. Focused on developing skills for effective classroom management and curriculum delivery.