Summary
Overview
Work History
Education
Skills
Certification
Timeline
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Jessica Dean

Medical Claims Processor
Phoenix

Summary

Dependable, proven leadership professional Medical Claims Analyst with 3 years experience in successful time management and independent working experience progressive experience in the field who is highly organized and detail-oriented.

Overview

3
3
years of professional experience
4
4
years of post-secondary education
3
3
Certifications

Work History

Cognizant

Cognizant
Phoenix, AZ
10.2020 - 03.2022
  • Pay or deny claims according to the benefit summary paper and electronic.
  • Review membership eligibility for determination
  • Assign the correct provider for proper payment
  • Follow all HIPAA guidelines
  • Review member's out of pocket for correct cost share application
  • Review COB information and apply it accordingly
  • Review Error codes, warning messages, and edits for correct processing
  • Analyze claims for correct payment verification and adjust where needed
  • Use the Facets system to adjudicate claims
  • Calculated other insurance and benefits
  • Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
  • Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
  • Posted and adjusted payments from insurance companies.
  • Enter all correspondence/EOBs received into the computer.
  • Update patient demographics, including insurance company information and financial class changes.
  • Keep EOB review and interpretation current.

Service Desk Associate / Central Dispatcher

Amazon
Tempe, AZ
06.2019 - 08.2020
  • Answers inquiries Coordinate rescue support between two drivers Interpret information from different sources to determine the best course of action todrive delivery success
  • Communicate with delivery partners ensuring on-time delivery
  • Solve for planned and unplanned events (traffic, weather, sporting, community)
  • Reported traffic and transportation delays, accidents, and other issues
  • Trained over 30 employees on accurate triaging and dispatching procedures while personally handling 30 daily calls
  • Established schedules, implemented new policies, and collaborated with managers to improve operational procedures and set clear goals.

Claims Representative

WageWorks
Tempe, AZ
06.2017 - 03.2018
  • Answered an average of 50 calls per day by addressing customer inquiries, solving problems, and providing new product information
  • Described products to customers and accurately explained details and care of merchandise
  • Follow all HIPA guidelines
  • Review member's out of pocket for correct cost share application
  • Review COB information and apply it accordingly
  • Review Error codes, warning messages, and edits for correct processing
  • Analyze claims for correct payment verification and adjust where needed
  • Use of the Facets system to adjudicate claims
  • Assign the correct provider for proper payment
  • Follow all HIPAA guidelines
  • Update patient demographics, including insurance company information and financial class changes.
  • Calculated other insurance and benefits.
  • Assign the correct provider for proper payment
  • Follow all HIPAA guidelines

Education

High School Diploma -

Compadre High School
Tempe, AZ
08.2011 - 05.2015

CPC - Medical Insurance Coding

Coding Clarified
Apache Junction, AZ
03.2022 - 10.2022

Skills

HCPCS Level IIundefined

Certification

High School - 2015

Timeline

CPC - Medical Insurance Coding

Coding Clarified
03.2022 - 10.2022

Cognizant

Cognizant
10.2020 - 03.2022

Service Desk Associate / Central Dispatcher

Amazon
06.2019 - 08.2020

Claims Representative

WageWorks
06.2017 - 03.2018

High School Diploma -

Compadre High School
08.2011 - 05.2015

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Jessica DeanMedical Claims Processor