Jasbir Singh
Blue Shield of California
Citrus Heights,CA
30
years of professional experience
Provider Enrollment Processor handling provider eligibility review, enrollment updates, and record corrections across PIMS and Facets. Supports ERA and EFT enrollment documentation, resolves payment-related provider issues, and communicates policy and authorization requirements clearly to contracted providers. Guides new processors through training and strengthens record integrity through careful issue tracking and resolution.
Work History
PROVIDER ENROLLMENT PROCESSOR
7 Years 6 Months- Reviewed provider eligibility requirements and contract details for compliance and accuracy.
- Processed provider updates, demographic changes, and directory corrections in systems.
- Communicated policy guidelines and authorization requirements to contracted providers.
- Tracked provider issues and recorded resolutions to strengthen record integrity at Blue Shield of California.
- Partnered with internal teams to update ERA and EFT enrollment documentation and expedite bank name updates in PIMS and Facets for provider payment issues and claim payment delays. Guided three groups of new processors through training, ensuring they grasped essential skills. of new processors released from training during current year.
CLAIMS ACTIVITY SUPPORT AND ADJUDICATION PROCESSOR
12 Years 8 Months- Processed Blue Shield of California claims using policy guidelines and member records.
- Reviewed benefit details and eligibility for Blue Shield of California accounts.
- Resolved routine processing issues for Blue Shield of California customer files, ensuring accurate claims processing.
- Entered accurate data into Blue Shield of California processing systems.
- Communicated status updates to Blue Shield of California internal departments. Processed complex cases and reached out to other Blue Shield support team to resolve incorrect claims adjusted by vendors. Coordinated benefits with other insurance carriers, processing coordination of benefits claims for Blue Shield of California accounts.
ENROLLMENT PROCESSOR AND INSPECTOR
2 Years 7 Months- Managed member enrollment records for Medicare Supplement and Small Group Employer Plans with careful attention to accuracy.
- Coordinated enrollment updates with internal service departments to resolve discrepancies and maintain clean account data.
- Inspected data using specialized tools to document findings and support timely communication between processors and auditors.
BILLING SPECIALIST
7 Years 2 Months- Resolved claim denials with payers and billing staff to move unresolved accounts through the billing cycle.
- Verified insurance coverage and patient eligibility before billing to reduce preventable claim errors.
- Processed patient billing for family medicine visits and procedures with consistent attention to coding and charge accuracy.
- Posted payments, adjustments, and refunds in billing records to keep account balances current and traceable.
- Answered patient billing questions clearly and professionally while correcting billing errors and issuing refunds when needed.
Education
Associate of Science - Administration Medical Assistant
Skills
Provider enrollment
Enrollment data correction
Provider directory maintenance
Claims adjudication
Coordination of benefits
Claim payment resolution
Eligibility verification
Contract compliance
Authorization requirement review
ERA EFT
Facets administration
Enrollment documentation
Accomplishments
- Mental Health documentation improving mapping project for Claims 2019
- Mental Health Recoupment 2018 Audited mental health claims for Corporate Recovery
- ERA EFT enrollment documentation update, visual presentation with SIU team for non-participating providers and Medicare Crossover providers. 2026
- Solera Wellness Program Project 2017 Analyzing claims issue on unpaid claims for preventative diabetes wellness program
Timeline
PROVIDER ENROLLMENT PROCESSOR
Blue Shield of California
04.2019 - CurrentRead More
CLAIMS ACTIVITY SUPPORT AND ADJUDICATION PROCESSOR
Blue Shield of California
08.2006 - 04.2019Read More
ENROLLMENT PROCESSOR AND INSPECTOR
Blue Shield of California
12.2003 - 07.2006Read More
BILLING SPECIALIST
Associated Family Physicians
10.1996 - 12.2003Read More
Heald College - CA
Associate of Science from Administration Medical Assistant
Read More