Mica Moultrie
Marion,IL
Summary
Knowledgeable Medical Claims Analyst with extensive experience in analyzing and processing claims accurately and efficiently. Proven track record in resolving complex claims and ensuring compliance with industry standards. Demonstrated ability in utilizing analytical skills and attention to detail to support team goals and improve operational processes.
Overview
16
16
years of professional experience
Work History
Claims Analyst/Computer Data Entry Operator
Wisconsin Physician Service Health Insurance, WPS
03.2014 - 03.2025
- Maintained strict confidentiality with all personal data as per company guidelines.
- Managed high-volume caseloads, prioritizing tasks to ensure timely completion of all claims.
- Maintained compliance with industry regulations and company policies while managing sensitive client information and claims records.
- Demonstrated a high level of accuracy and attention to detail in reviewing claim documentation for approval or denial decisions.
- Reviewed submitted claim information a selected the correct procedure and/or diagnosis code(s) using manuals (ICD 10, CPT4, HCPCS).
- Corrected claim information and adjudication errors.
- Obtained and analyzed claims data to determine specific problem areas, including external communications to obtain data.
- Determined medical review referral of claims based on contract requirements and diagnoses.
Case Manager
Asurion
05.2009 - 03.2014
- Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
- Educated clients on available programs and services, empowering them to make informed decisions about their needs.
- Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions.
- Contributed to team discussions and case conferences actively, sharing insights and expertise with colleagues to optimize client support strategies.
Education
AAPC
High School Diploma -
Marion High School
Marion, IL05-2000
Skills
- Working knowledge of Medicare and Tricare claims
- Interpersonal and written communication
- Policy interpretation
- MS office
- Computer skills
- Knowledge of HIPPA Laws
Timeline
Claims Analyst/Computer Data Entry Operator
Wisconsin Physician Service Health Insurance, WPS
03.2014 - 03.2025
Case Manager
Asurion
05.2009 - 03.2014
AAPC
High School Diploma -
Marion High School
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