Summary

Overview

Work History

Education

Skills

Timeline

Megan Morrow

Stearns

Summary

Was a Medical Claims Associate with HealthNet Federal Services, I'm skilled in QNXT and HIPAA compliance. Proven track record in enhancing claims processing accuracy and resolving complex issues. Adept at effective communication and multitasking, ensuring timely approvals while delivering exceptional customer service. Committed to maintaining regulatory standards and improving operational efficiency.

Overview

7

7

years of professional experience

Work History

Medical Claims Associate

HealthNet Federal Services

09.2018 - 03.2025

Examined claims forms and other records to determine insurance coverage.
Maintained compliance with state regulatory requirements through meticulous documentation and adherence to company policies.
Evaluates the accuracy of these updates/changes as applied to the appropriate modules within the core claims processing system (QNXT).
Analyzed policy details along with supporting documents provided by healthcare providers to make informed decisions on claims approvals or denials.
Spoke with healthcare providers to obtain necessary documentation for claim support.
Implemented quality control measures to reduce errors and improve overall accuracy rate in claims processing.
Resolved claims issues for expedited processing and resolution.
Reviewed provider coding information to report services and verify correctness.

Education

High School Diploma -

McCreary Central Highschool

Stearns, KY

05-2017

Skills

HIPAA compliance awareness
Effective communication
Microsoft Excel, Word, Outlook, and teams
QNXT
PEGA

Medicare and Medicaid
Claims Viewer
Claims processing proficiency
Multitasking
Meet deadlines and provide excellent customer service skills

Timeline

Medical Claims Associate

HealthNet Federal Services

09.2018 - 03.2025

High School Diploma -

McCreary Central Highschool