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
2024.04 - 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
2012.08 - 2023.04
- 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, KY1990-02
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
2024.04 - Current
Claims Processor
Goldcoast Healthcare
2012.08 - 2023.04
GED -
Lafayette High School
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