Marquise Mccullah
jacksonville
Summary
Efficient Claims Adjuster with expertise in claims processing, data analysis, and regulatory compliance. Proficient in claims management software (Guidewire, Xactimate) and Microsoft Office. Skilled at collaborating with teams to meet deadlines while ensuring accuracy and quality. Adept at problem-solving and leveraging automation tools to enhance productivity.
Overview
9
9
years of professional experience
Work History
Claims Adjuster
Florida Blue - Blue Cross Blue Shield Of Florida
Jacksonville
05.2021 - Current
- Assess and analyze complex claims to ensure accuracy in evaluating claims, and gathering necessary information to prevent errors.
- Effectively communicate with claimants, medical professionals, and other parties to facilitate smooth claim processing.
- Efficiently corrected and cleared aged medical claims, reducing processing delays, and improving claims cycle time.
- Accurately processed claims on a daily basis, contributing to the company’s achievement of annual quality and quantity targets.
- Proficient in claims management software, databases, and office tools (e.g., Microsoft Office, Excel).
- Flexible to adjust to changing regulations, technologies, and client needs in the evolving insurance landscape.
Hold Code Representative
Florida Blue - Blue Cross Blue Shield Of Florida
Jacksonville
06.2018 - 05.2021
- Resolved and cleared aged medical claims on hold, ensuring accurate processing, and reducing backlog delays.
- Collaborated with a cross-functional team to meet strict claim processing deadlines, while ensuring compliance with quality standards.
- Effectively trained new team members, enabling them to quickly contribute to claim inventory processing with accuracy and efficiency.
Claims Examiner
Florida Blue - Blue Cross Blue Shield Of Florida
Jacksonville
05.2016 - 05.2018
- Accurately keyed and processed claims data into the claims management software, ensuring compliance with company standards and minimizing errors.
- Collaborated with medical professionals and examiners to verify and process claims efficiently, meeting or exceeding timeliness benchmarks.
- Leveraged Microsoft Word and Excel to document, organize, and analyze claims data, improving accuracy and streamlining administrative tasks.
Education
Bachelor of Science - Information Technology
Daytona State College
Daytona Beach, FL05-2023
Skills
- Claims processing
- Regulatory compliance
- Claims management software
- Data analysis
- Medical terminology
- Customer service
- Microsoft Office
- Time Management & Efficiency
- Digital Literacy
- Communication & Collaboration
Timeline
Claims Adjuster
Florida Blue - Blue Cross Blue Shield Of Florida
05.2021 - Current
Hold Code Representative
Florida Blue - Blue Cross Blue Shield Of Florida
06.2018 - 05.2021
Claims Examiner
Florida Blue - Blue Cross Blue Shield Of Florida
05.2016 - 05.2018
Bachelor of Science - Information Technology
Daytona State College
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