Flor Jung
Gonzales,CA
Summary
Experienced in the processing of health insurance claims in accordance with the terms of the individual benefit contracts.. Knowledge of medical terminology, insurance billing and coding. Ability to operate software programs and office equipment required to fulfill the position responsibilities.
Overview
27
27
years of professional experience
Work History
Medical Claims Analyst
Coastal TPA
Monterey, CA
12.1998 - 02.2026
- Demonstrated respect, friendliness, and willingness to help wherever needed.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Used critical thinking to break down problems, evaluate solutions, and make decisions.
- Responsible for processing health insurance claims in accordance with the terms of individual benefit contracts.
- Knowledge of ICD-10, CPT, HCPC codes
- Coordinate benefits with other group health plans.
- Referred appropriate claims, pre-certifications and appeals to medical review.
- Ensured accurate payments by meticulously reviewing medical records, invoices, and supporting documentation.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Paid or denied medical claims based upon established claims processing criteria.
Education
Medical Office Administration
Central Coast College
Salinas, CANo Degree - General Studies
Hartnell College
Salinas, CAHigh School Diploma -
King City High School
King City, CASkills
- Claims processing and data entry
- HIPAA compliance
- Medical terminology
- Knowledge of ICD-10, CPT, HCPC
- Problem-solving
- Teamwork
- Reliability
- Bilingual
Timeline
Medical Claims Analyst
Coastal TPA
12.1998 - 02.2026
Medical Office Administration
Central Coast College
No Degree - General Studies
Hartnell College
High School Diploma -
King City High School