Methodical Claims Processing Clerk known for high productivity and efficient task completion. Possess specialized skills in claim evaluation, data entry accuracy, and regulatory compliance. Excel at time management, problem-solving, and communication, ensuring smooth operation within fast-paced environments. Seasoned Claims Processor evaluating online entry, error correction and quality control review for final adjudication of claims. Strong business and financial acumen with proven success to maintain efficient operations. Extensive knowledge of billing, collections and fiduciary management.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Claims Processing Clerk
Walmart
Hialeah, FL
11.2001 - 07.2025
Addressed customer inquiries to provide information and explanations on coverage and terms, expediting claims.
Assisted claimants, providers and clients with problems or questions regarding claims.
Managed workload to meet or exceed productivity and quality standards.
Responded to external audits by providing requested claims documentation and explanations.
Department Manager
Walmart
Hialeah, FL
11.2001 - 07.2025
Followed safety protocols and company processes and procedures.
Executed targeted merchandising and promotional plans to meet department sales goals.
Enforced safety rules and other policies to protect employees and minimize company liability.
Education
Associate of Science - Radiologic Technology
Medacademy
Hialeah, FL
Skills
Data entry proficiency
Workflow management
Verbal communication
Insurance regulations
Professionalism and ethics
Medical terminology
Claims review
Transactions reconciliation
Accuracy and precision
Claims
Policy interpretation
Regulatory compliance
Affiliations
I like to perform outdoor activities like hiking, camping, fishing etc.