Karen Moore

Jobs 0% verified

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Operations Manager

Docs2go

Aug 2023 - Mar 2025 (1 year 8 months)

• Led a team of 10 notary schedulers • Managed hiring, onboarding, and training of staff • Created operations manual to standardize workflows • Negotiated contracts and service rates with notaries and process servers
Claims Specialist

Evry Health

Mar 2022 - Jul 2023 (1 year 5 months)

• Audited employer-based health insurance claims • Performed configuration testing and data validation • Ensured compliance with internal claims processing standards • Processed long-term care claims for Medicaid and Medicare enrollees • Created and maintained rate templates to support adjudication accuracy
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Claims Adjudication Specialist

iCircle

Jul 2017 - Mar 2022 (4 years 9 months)
Claims Examiner

Excellus BCBS

Jan 2016 - Jan 2017 (1 year 1 month)

• Reviewed complex claims and determined liability. • Reconciled No-Fault, Subrogation, and Workers' Comp claims. Additionally, utilized Microsoft 365 to document my work efficiently, ensuring accurate record-keeping and streamlined communication throughout the claims process.
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Analysis & Recovery Analyst (Contract)

The Judge Group for Excellus BCBS

Jan 2015 - Jan 2016 (1 year 1 month)

• Conducted payment status audits • Requested and tracked claim refunds for overpayments or underpayments
Customer Service Representative

Farmers Insurance

Jan 2014 - Jan 2015 (1 year 1 month)

• Assisted customers with eligibility, policy changes, and claims inquiries
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Sr. Member Services Rep / Claims Auditor / Medicare Coordinator

MVP Healthcare

Jan 2001 - Jan 2014 (13 years 1 month)

• Audited claims for accuracy and compliance • Handled complex provider disputes and appeals • Medicare subject matter expert • Managed escalations and grievances

Education 0% verified

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