Jan Strickland
Gainesville,GA
Summary
Effective Medical Claims Processor with strong background building rapport with providers, clients, and insureds to discuss claim status or claim denials. Driven performer equipped to handle multiple administrative tasks effectively.
Overview
33
33
years of professional experience
1
1
Certification
Work History
Claims Examiner
Benefit Support, Inc.
08.2001 - Current
- Paid or denied medical and dental claims based upon established claims processing criteria.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Verified patient insurance coverage and benefits for medical and dental claims.
- Took all claims related calls from providers, employees, group contacts, and case management representatives.
- Alerted reinsurance carriers when any insured met 50% of specific or had possible large claim diagnosis.
- Created disclosure document for each of my accounts at plan renewal.
Medical Claims Examiner
Administrative Solutions
06.1999 - 08.2001
- Managed large volume of medical and dental claims on daily basis.
- Paid or denied medical claims based upon established claims processing criteria.
- Verified patient insurance coverage and benefits for medical claims.
- Took all claims related calls from providers, employees, group contacts, and case management representatives
Reinsurance Coordinator / Claims Examiner
Group Resources, Inc.
07.1990 - 06.1999
- Originally hired as claims examiner. I was promoted to Reinsurance Coordinator for last 3 years of employment.
- Generated monthly reports to determine any insureds who had exceeded specific amount.
- Gathered claims, eligibility information, work status, and all required information needed, and filed reinsurance claims to appropriate carriers.
- Responded to all inquiries from reinsurance companies.
- Documented receipt of reinsurance checks and forwarded to appropriate group contact for deposit.
Education
Clerical Diploma / 18 Courses - Office Administration
Lanier Technical College
Oakwood, GA06.1983
High School Diploma -
Johnson High School
Gainesville, GA06.1981
Skills
- Benefits Review
- Customer Service
- Provider Relations
- Medical Terms and Procedure Knowledge
- Liability Determinations
- Insurance Plan Verification
- Policy and Procedure Explanations
- Reinsurance Disclosure Reporting
Certification
Dean Vaughn Medical Terminology Certificate
Timeline
Claims Examiner
Benefit Support, Inc.
08.2001 - Current
Medical Claims Examiner
Administrative Solutions
06.1999 - 08.2001
Reinsurance Coordinator / Claims Examiner
Group Resources, Inc.
07.1990 - 06.1999
Clerical Diploma / 18 Courses - Office Administration
Lanier Technical College
High School Diploma -
Johnson High School
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