Hard working professional HIPAA certified medical claims processor with 15+ years’ experience and knowledge in the health claims industry also proficient in office administration, and customer service.
Overview
16
16
years of professional experience
2
2
years of post-secondary education
Work History
MEDICAL CLAIMS PROCESSOR
ELECTRICAL WELFARE TRUST FUND
Lanham, MD
02.2015 - 03.2023
Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
Managed large volume of medical claims on daily basis.
Respond to member inquiries concerning medical claims
Review and adjust claim as needed
Audit claims for errors and overpayments
ADMINISTRATIVE ASSISTANT
ELECTRICAL WELFARE TRUST FUND
Lanham, MD.
02.2008 - 01.2015
Operated computers for word processing, database management, and other applications
Run EDI 837 professional and institutional health claims file
Make edits to the EDI 837 report via provider matching for claims auto adjudication
Set up and maintained paper and electronic filing systems for records, correspondence, and other material
Located and attached appropriate files to incoming correspondence requiring replies
Executed record filing system to improve document organization and management.
SCAN TECHNICIAN
ELECTRICAL WELFARE TRUST FUND, PROMOTED
Lanham, MD
02.2007 - 02.2008
Open, sort and prep incoming mail to be scanned or distribute to the appropriate individual
Operated and troubleshooting office equipment such as fax machines, copiers, and scan machines to input claims data into the Eflo system for claims processing
Filed away documents to be stored once claims have been processed and completed
Trained new scan technicians on all aspects of the job
Complied with HIPAA and company regulations to maintain confidentiality regarding patient health data and medical records.
Education
Business Management
Prince George’s Community College
09.2004 - 12.2006
CompTIA A+ - Information Technology
Per Scholas Sponsored By Google
Baltimore, MD
04.2023 - Current
Associate of Applied Science - Health Information Technology
Eastern Gateway Community College
Steubenville, OH
03.2023 - Current
Skills
Medical terms knowledge
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Timeline
CompTIA A+ - Information Technology
Per Scholas Sponsored By Google
04.2023 - Current
Associate of Applied Science - Health Information Technology
Eastern Gateway Community College
03.2023 - Current
MEDICAL CLAIMS PROCESSOR
ELECTRICAL WELFARE TRUST FUND
02.2015 - 03.2023
ADMINISTRATIVE ASSISTANT
ELECTRICAL WELFARE TRUST FUND
02.2008 - 01.2015
SCAN TECHNICIAN
ELECTRICAL WELFARE TRUST FUND, PROMOTED
02.2007 - 02.2008
Business Management
Prince George’s Community College
09.2004 - 12.2006
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