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James Huston
Hudson,Wisconsin
Summary
Expert in health insurance claims processing with a strong track record of ensuring accurate and timely payments. Adept at analyzing claims data, resolving issues, and maintaining comprehensive documentation to support operational excellence. Committed to enhancing customer satisfaction through effective communication and problem-solving strategies.
Overview
9
9
years of professional experience
Work History
Claims Specialist Associate
Prime Therapeutics
Mendota Heights, Minnesota
05.2015 - 02.2022
- Processed small claims to ensure timely payment
- Calculated claim amounts to ensure accurate processing.
- Transmitted claims for payment or further investigation to facilitate timely resolution.
- Contact insured or other involved persons to obtain missing information.
- Review insurance policy to determine coverage.
- Posted and attached relevant information to claim files for organized record-keeping.
- Organize or work with detailed office or warehouse records, using computers to enter, access, search or retrieve data.
Documentation Onboard
JetPubs, Inc
Hudson, Wisconsin
12.2014 - 03.2015
- Develop or maintain online help documentation.
- Edited and standardized materials prepared by other writers to maintain consistency and quality.
- Coordinated typing, duplication, and distribution of written materials to ensure timely access for stakeholders.
- Assisted in layout of publication materials to enhance readability and presentation.
- Organized and updated files and records of all work and revisions for easy access.
National Event Representative
20/20 Companies (T-Mobile)
Hudson, Wisconsin
07.2013 - 12.2014
- Confer with potential customers regarding equipment needs and advise customers on types of equipment to purchase.
- Direct and coordinate activities involving sales of manufactured products, services, commodities, real estate or other subjects of sale.
- Represent company at trade association meetings to promote products.
- Visited franchised dealers to generate interest in establishing or expanding leasing programs.
- Advised dealers and distributors on policies and operating procedures to enhance business functionality.
- Assess marketing potential of new and existing store locations, considering statistics and expenditures.
- Consulted with department heads to plan advertising services and gather information on equipment and customer specifications.
- Oversee regional and local sales managers and their staffs.
Education
Bachelor of Science -
Brown College
MN07-2007
High School Diploma -
Lamar High School
Meridian, MS05-1997
Skills
- Claims processing
- Claims management software
- Claims processing and management
- Data entry and documentation
- Documentation review
- Problem solving and decision-making
- Technical writing and documentation review
- Problem solving
- Programming languages and SQL management
- Tool adaptability
- Multi-tasking and team building
- Claims analysis
Timeline
Claims Specialist Associate
Prime Therapeutics
05.2015 - 02.2022
Documentation Onboard
JetPubs, Inc
12.2014 - 03.2015
National Event Representative
20/20 Companies (T-Mobile)
07.2013 - 12.2014
Bachelor of Science -
Brown College
High School Diploma -
Lamar High School