Amauri Grayer

I am always looking for opportunities to expand my career

Claims Examiner– AmeriHealth Caritas December 2021- April 2023

• Reviewed submitted claims to ensure accuracy, completeness, and compliance with company policies and procedures.
• Verified claim pricing, ensuring that it aligned with the appropriate fee schedules and provider agreements.
• Corresponded with members, group contacts, agents, and healthcare providers to provide written and verbal information related to claim status, denials, and payment issue.
• Collaborated with colleagues to identify process improvements to enhance efficiency and accuracy in claims processing.
• Verified diagnosis and procedure codes to ensure that they met state guidelines.
• Processed Coordination of Benefits, when needed.
• Focused on technical aspects of claims handling, striving to meet high production standards.

Associate of Arts in Language Arts, Florida State College at Jacksonville (2019)

High School Diploma, Frank H. Peterson High School (2019)