Effective Medical Claims Processor with a strong background in building rapport with providers to discuss claim status or denials. Driven performer equipped to handle multiple administrative tasks effectively, with highly investigative skills in claims processing.
Work History
CLAIMS PROCESSOR
1 Year 6 Months
Winston Benefits | 05.2024 - 11.2025
Processed high volumes of medical claims accurately and efficiently under tight deadlines, ensuring prompt payment for services rendered.
Researched and resolved complex medical claims issues, facilitating timely payment for providers.
Streamlined workflows and implemented best practices, enhancing claim processing efficiency.
Applied meticulous attention to detail and thorough review processes, minimizing errors in claims submissions.
Worked remotely to manage tasks efficiently
FINANCIAL SERVICES REPRESENTATIVE
1 Year 3 Months
PNC BANK | 02.2023 - 05.2024
Delivered exceptional customer service by promptly resolving issues and fostering long-term client relationships.
Enhanced customer satisfaction by addressing and resolving financial inquiries in a timely manner.
Assisted in fraud prevention efforts by closely monitoring customer accounts and reporting suspicious activity as required. Streamlined customer inquiry processes, leading to a noticeable reduction in response times and enhanced client satisfaction.
Monitored customer accounts closely and reported suspicious activity to support fraud prevention efforts. Streamlined customer inquiry processes, leading to a noticeable reduction in response times and enhanced client satisfaction.
Remote
CLAIMS PROCESSING SPECIALIST
8 Months
Convergys | 09.2021 - 05.2022
Achieved departmental goals by meeting or exceeding performance metrics for quality and quantity of processed claims.
Leveraged advanced software tools to quickly identify discrepancies, leading to more accurate claims decisions.
Investigated and rectified billing discrepancies, facilitating accurate billing.
Resolved billing variances, ensuring system accuracy and currency.
Worked remotely to complete assigned tasks efficiently.
Education
High School Diploma
Kendrick High School | Columbus, GA | 05-2012
Associate Degree in Nursing - Medical Informatics
Ultimate Medical Academy | Clearwater, FL | 10-2026
Skills
Claims Reconciliation
Claims Integrity
Regulatory compliance
Healthcare Knowledge
Accuracy and precision
Professionalism and ethics
Accomplishments
Used Microsoft Excel to develop inventory tracking spreadsheets.