Duane Churchill

Claims Analyst @Christian Care Ministry

Melbourne, FL, US

Key Responsibilities:Analyze and process medical bills, making informed determinations to approve, deny, or request additional information based on Medi-Share program guidelines.Research diagnoses, treatment plans, and medical procedures to ensure accuracy, necessity, and compliance with program standards.Maintain a production rate of 50 bills per hour while ensuring 90%+ accuracy in claims adjudication.Communicate with internal teams, healthcare providers, and members to gather information and clarify billing details.Utilize Salesforce and multiple database systems to manage and track claims efficiently.Apply strong analytical, reasoning, and problem-solving skills to interpret medical records, insurance policies, and legal documents.Work independently in a remote setting, navigating multiple software platforms to ensure seamless claims processing.Familiarity with ICD-10, HCPCS, CPT coding, HCFA 1500 & UB-04 to assess medical claims accurately and ensure correct billing procedures.Key Achievements: Improved accuracy and efficiency in claims adjudication through data analysis and process optimization. Contributed to maintaining compliance with Medi-Share guidelines and industry best practices. Developed expertise in Salesforce CRM, document imaging systems, and medical billing software.

Eastern Florida State College

Network Support Technology Certificate