Rosie

Health Insurance VA| Medical Claims | QA | Admin Assistant

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Overview

Looking for full-time work (8 hours/day)

at $6.98/hour ($1,344.00/month)

Bachelors degree

Last Active

June 26th, 2026 (today)

Member Since

May 4th, 2022

Profile Description

Hello! I’m ---------- , a seasoned professional with over 14 years
of experience in the U.S. health insurance industry, specializing in medical
claims processing, Medicare prescription drug plan (Part D), quality assurance,
and administrative support. Throughout my career, I’ve handled a wide range of
responsibilities, including:

- Medical Claims Processing – Accurate and
timely review of claims following U.S. healthcare guidelines and payer
policies.

- Quality Assurance Analyst – Responsible for performing quality checks on the grievance process, document processing, billing, reconciliation, and plan enrollment to ensure workflows are in accordance with plan rules and compliant with CMS regulations.

- Document, File Management, Eligibility Verification - Experienced in managing enrollment files, verifying member's eligibility, and reconciling discrepancies between client and payer systems.

Administrative & VA Tasks – Calendar/email management, data entry, customer service, documentation, and other back-office support tasks for healthcare clients.

Tools & Platforms:
Facets / Pharmacy Benefits system
Microsoft Office (Excel, Outlook, Word)
Google Workspace (Docs, Sheets, Gmail)
Zoom, Canva, Hubspot, Availity, Epic