Claims Examiner with deep knowledge of medical claims industry. Solid abilities in developing objectives and strategies to settle medical claims. Excellent skills compiling, coding, categorizing and auditing information to process claims.
Overview
32
32
years of professional experience
Work History
Claims Adjudicator
CASCI (Capitol Area Servic Company Inc) BCBS Insurance
Collaborated with team members and management to meet goals.
Communicated with clients to explain policy coverage and regulations.
Executed claims processing, while generating increased revenue.
Spearheaded employee development initiatives to increase productivity.
Investigated high volume of insurance claims to determine validity and coverage eligibility.
Verified insurance claims and determined fair amount for settlement.
Finalized Type files for insurance claim payment release.
Newspaper Carrier. Delivery
H D Media
Charleston, WV
01.1991 - Current
Organized and mapped efficient delivery routes to boost daily delivery numbers.
Completed punctual early morning loading and unloading of newspapers at distribution center.
Picked up newspapers from main facility and loaded into vehicle in preparation for deliveries.
Reviewed routes and expected delivery time to determine proper order of deliveries and anticipated potential delays.
Delivered newspapers and flyers to about 600 homes daily.
Education
No Degree - Business Administration
Marshall University
Huntington WV
09.2009
Diploma - General And College Prep
South Charleston High School
South Charleston WV
06.1973
Skills
Case Presentations
Title Examination
Inputting Claims
Claim Validity Determination
Claims Evaluations
Claims Understanding
Claim Form Analysis
Correcting Errors
HIPAA Regulations
Policy Changes
Customer Inquiries
Purchase Orders
Timeline
Newspaper Carrier. Delivery
H D Media
01.1991 - Current
Claims Adjudicator
CASCI (Capitol Area Servic Company Inc) BCBS Insurance
No Degree - Business Administration
Marshall University
Diploma - General And College Prep
South Charleston High School
Similar Profiles
Cheryl ParkerCheryl Parker
Sr. Business Process Analyst-Business Optimization at CASCISr. Business Process Analyst-Business Optimization at CASCI