Johnny Le
Plainfield,IL
Summary
Effective Medical Claims Processor with strong background building rapport with providers to discuss claim status or claim denials. Driven performer equipped to handle multiple administrative tasks effectively. Exemplary worker with highly investigative skills when processing claims. Results-driven professional provides customers with tailored solutions to meet needs. Successfully establishes relationships with customers and delivers quality service. Agile individual with excellent communication and customer service skills. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
1
1
year of professional experience
Work History
Medical Insurance Specialist
Kiddos Health And Urgent Care
06.2023 - Current
- Responded to correspondence from insurance companies.
- Reviewed provider coding information to report services and verify correctness.
- Managed large volume of medical claims on daily basis.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Paid or denied medical claims based upon established claims processing criteria.
- Verified patient insurance coverage and benefits for medical claims.
- Generated reports on medical claims processing activities and results.
- Researched and resolved complex medical claims issues to support timely processing.
Independent Business Owner
Amway
11.2022 - 06.2023
- Provided elite customer service by resolving escalated problems and calmly responding to shifting priorities.
- Promoted business via social media to generate leads and maximize brand identity.
- Introduced new methods, practices, and systems to reduce turnaround time.
- Implemented process improvement to shape organizational culture, optimize procedures for higher efficiency and help company evolve and grow.
Education
Bachelor of Arts - Psychology
Benedictine University
Lisle, IL05.2021
High School Diploma -
Oswego East
Oswego, IL05.2016
Skills
- Eligibility Checks
- Thorough Claims Reviews
- Customer Satisfaction
- Active Listening
- Customer Service
- Microsoft Project
- Medical Terminology
- Health Insurance Industry Knowledge
- Patient Admission
- Critical Thinking
- Provider Relations
- Insurance Coverage Verification
Accomplishments
- Supervised team of 12 staff members.
- Used Microsoft Excel to develop inventory tracking spreadsheets.
- Completed and submitted accredited research
- Worked in an environment requiring adaptability
- Resolved product issue through consumer testing.
- Completed Cybersecurity certificates from Google on CourseA.
Passions
- Passion for physical fitness and overall health
- Passion for updated and new technology and software
Languages
English
Native or Bilingual
Vietnamese
Limited Working
Timeline
Medical Insurance Specialist
Kiddos Health And Urgent Care
06.2023 - Current
Independent Business Owner
Amway
11.2022 - 06.2023
Bachelor of Arts - Psychology
Benedictine University
High School Diploma -
Oswego East
Similar Profiles
Yesenia CollettYesenia Collett
Supervisor /HR Management at 777 Urgent Care / Bridlewood Family Health CareSupervisor /HR Management at 777 Urgent Care / Bridlewood Family Health Care
Eunice WiafeEunice Wiafe
Family Nurse Practitioner Student at ELGREAT HEALTH CARE/ STAFFORD URGENT CAREFamily Nurse Practitioner Student at ELGREAT HEALTH CARE/ STAFFORD URGENT CARE
Yelitza JonesYelitza Jones
LPN at Hartford Health Care Urgent CareLPN at Hartford Health Care Urgent Care