Summary
Overview
Work History
Education
Skills
Timeline
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Ella Shaw

Lexington,KY

Summary

Detailed claims processor with several years of experience investigating claim information for correctness. Trustworthy teammate with benefit knowledge and rapport-building skills. Noted for thoroughness and ethical customer service.

Overview

12
12
years of professional experience

Work History

Claims Processor

Personify Health
Lexington, KY
04.2024 - Current
  • Processed a high volume of incoming claims in accordance with established policies and procedures.
  • Reviewed and verified insurance policy information to assess coverage and determine appropriate claims processing procedures.
  • Identified trends in denials or rejections due to incorrect coding or billing practices by providers.
  • Performed additional duties as requested by management team.

Claims Processor

Goldcoast Healthcare
Lexington, KY
08.2012 - 04.2023
  • Processed a high volume of incoming claims in accordance with established policies and procedures.
  • Provided exceptional customer service by addressing inquiries promptly and professionally.
  • Resolved complex issues associated with denied or underpaid claims through negotiation with payers.
  • Researched discrepancies between submitted documentation and actual records to identify errors or omissions.
  • Performed additional duties as requested by management team.

Education

GED -

Lafayette High School
Lexington, KY
02-1990

Skills

  • Claims review
  • Transactions reconciliation
  • Payments posting
  • Allocating claims
  • Medical terminology knowledge
  • Policy Interpretation
  • Accuracy and Precision
  • Data Entry
  • Microsoft Office
  • Decision-Making
  • Time management abilities
  • Attention to Detail
  • Recordkeeping Organization
  • Self Motivation

Timeline

Claims Processor

Personify Health
04.2024 - Current

Claims Processor

Goldcoast Healthcare
08.2012 - 04.2023

GED -

Lafayette High School

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Ella Shaw