Jennifer Leigh Clark
2500 N Desert Links Dr 5104, Tucson,AZ
Summary
Detail-oriented claims processor with 5+ years of experience managing insurance claims. Skilled in claims systems, Epic Tapestry, IDX, EZ-CAP from 3 large (Managed Care) insurance companies. Frequently praised as hard-working by upper management at UCSD. Recognized for strong analytical skills, excellent 10-keying, clear communication, and the ability to resolve complex issues while remaining focused.
Overview
20
20
years of professional experience
Work History
Medical Claims Processor AND Data Entry Specialist
Professional Development - Career Transition
09.2023 - Current
- Expanding knowledge in healthcare administration, eligibility/enrollment and data validation.
- Focused on resume optimization and ATS strategies for competitive job markets.
Processor - Dental Claims (Remote)
Skygenusa.com
10.2022 - 08.2023
- Resolved complex dental claims and Prior Authorization Requests for accuracy while maintaining high customer satisfaction scores.
- Evaluated dental treatment plans and documentation (EOB, Remit) to determine eligibility and coverage limits.
- Maintained production records and documentation, ensuring accuracy and completeness for reporting purposes.
Processor - Medical Claims
UCSD HIM/CLAIMS DEPARTMENT
06.2019 - 02.2022
- Claims Processing: Resolved complex claims efficiently while maintaining high customer satisfaction scores.
- Three (3) years' experience working in managed care and eligibility.
- Data Entry: Entered patient information and claim details into the claims management system efficiently and accurately.
- Accurately entered and updated patient encounter data into Epic Tapestry, ensuring compliance with HIPAA regulations.
- Managed high-volume data entry tasks with attention to detail, maintaining an average accuracy rate of over 98% accurate.
Encounters Specialist (data entry)
UCSD/MEDICAL RECORDS
01.2017 - 01.2018
- Converted data from paperwork into Epic Tapestry.
- Implemented strategies to improve performance, accuracy and quality.
- Preserved customer confidence and protected operations by keeping information confidential.
- Use of Calculator for batch totals to match the UCSD coders totals.
Examiner I (MNR Claims)
American Specialty Health
11.2013 - 10.2015
- MNR Claims: Gained valuable insurance claims experience processing Medical Necessity Review claims with a focus on accuracy and compliance, received from faxes.
- Phone Calls: Outbound phone calls to provider for missing information.
- Paper Claims: Developed a strong proficiency in evaluating and processing MNR claims for accuracy and compliance.
Data Entry - Billing
Vericare Management
04.2012 - 10.2012
- Met deadlines while maintaining high-quality deliverables.
- Data Entry of behavioral claims received daily.
- Opening mail, sorting, entering patient information.
Processor - Medical Claims
Americhoice (part of UHC)
08.2008 - 03.2011
- Resolution: Resolved complex claims (paper and electronic) efficiently while maintaining high customer satisfaction scores with IDX claims processing system.
- MS Access: Completed claims are logged into Access on a daily basis.
- Verification: Checked patient information on claims, checking for and preventing mistakes.
Data Management Specialist
Dataquick Information Services
07.2006 - 01.2008
- Optimized existing database schemas for improved query performance against large datasets stored in data warehouses.
- Performed data profiling and cleansing activities using related toolsets.
Processor - Medical Claims
Southern CA Physicians
09.2005 - 07.2006
- EZ-CAP: Processed paper and electronic medical claims, ensuring accuracy.
- Pulled batches by oldest date, enter the entire claim and reimbursement amounts, making sure correct.
Education
High School Diploma - General Education, Math and Business
Rio Lindo Academy
Healdsburg, CASkills
- Medical terminology
- Data entry and accuracy
- Claims Processing systems, Epic Tapestry, IDX, EZ-CAP, CMS-1500 and UB-04
- Perceptive Content, ImageNow and Enterprise (dental claims)
- Analytical and problem-solving skills
- MS Office: Word, Access, Excel, Outlook
- Current typing speed is 50-60 WPM
- 11,000 KSPH, 98% accuracy ratio
- Attention to Detail
- Communication (written and verbal)
- Time Management
- Empathy and customer service
- Conflict Resolution
- Adaptability
Timeline
Medical Claims Processor AND Data Entry Specialist
Professional Development - Career Transition
09.2023 - Current
Processor - Dental Claims (Remote)
Skygenusa.com
10.2022 - 08.2023
Processor - Medical Claims
UCSD HIM/CLAIMS DEPARTMENT
06.2019 - 02.2022
Encounters Specialist (data entry)
UCSD/MEDICAL RECORDS
01.2017 - 01.2018
Examiner I (MNR Claims)
American Specialty Health
11.2013 - 10.2015
Data Entry - Billing
Vericare Management
04.2012 - 10.2012
Processor - Medical Claims
Americhoice (part of UHC)
08.2008 - 03.2011
Data Management Specialist
Dataquick Information Services
07.2006 - 01.2008
Processor - Medical Claims
Southern CA Physicians
09.2005 - 07.2006
High School Diploma - General Education, Math and Business
Rio Lindo Academy