Quinn Crawford
Nichols,SC
Summary
Looking to add to team success by applying solid education and experience. Authorized to work in the US for any employer
Overview
13
13
years of professional experience
Work History
Claims Processor II
Blue Cross Blue Shield
04.2022 - Current
- Review, recoup, and adjudicate complex or specialty claims
- Performs claims history research
- Update OHI files
- Resolves claims accurately while meeting production quota
- Determines whether to return, deny, or pay claims following company policies and procedures
- Assists in training or mentoring new staff members
- Updates database for monthly reporting
- Performs preliminary recoupment requests
- Creates case files and records data accurately.
Special Education Paraprofessional
Horry County Schools
Conway, SC
04.2020 - 04.2022
- Assist with the implementation of Individualized Education Programs for students with disabilities under the direction of the classroom teacher(s) and/or service provider(s)
- Assist with individual or small group instruction developed and supervised by the teacher in the assigned class(es) including but not limited to teaching, re-teaching and reviewing lessons, asking questions and prompting students and/or guiding independent work
- Attends to the needs of students with disabilities that may include personal hygiene, lifting, feeding, toileting, monitoring supportive medical equipment, i.e., walkers, wheelchairs, etc
- And/or facilitating the use of assistive technology
- Escorts and supervises students not limited to daily arrival and school departure, transitions between classes, the playground, cafeteria, transporting to and/or from school and/or off-site learning activities
- Collects, charts and reports student performance data to teachers and/or other service providers
- Performs general clerical tasks for assigned classroom, including maintaining student records (i.e., data books, portfolios, assignment folders)
- Distributes and collects instructional materials and reports
- Assists with behavioral management programs in the classroom and implements behavior intervention plans and/or plans for independence for individual students
- Successfully participates in designated staff development needed to fulfill job duties
- Paraprofessionals who may be required to physically restrain students to ensure their safety and the safety of others will be provided appropriate staff development
- Communicates with parents only under the direction and supervision of a teacher
- Serves as an educational team member who collaborates and supports the efforts of school staff and the needs.
Teacher Assistant
Waccamaw, EOC
Green Sea, SC
01.2019 - 04.2020
- Assisted in preparation and implementation of daily lesson plans
- Assisted in implementation, coordination, and evaluation of approved center activities (classroom, outside, field trips, etc.)
- Assisted in supervision of children in large and small group activities
- Ensured that children were safely buckled in child restraint systems while traveling on bus
- Ensured that children stay seated and are supervised while in transit
- Ensured that children were escorted from bus to guardian safely.
After School Teacher
Horry County Schools
Loris, SC
09.2017 - 03.2018
- Assisted children with homework
- Expanded student's knowledge by using fun ways to study concepts
- Organized and engaged in recreational activities including outdoor/indoor sports and STEM activities
- Addressed behavioral and learning issues with parents and management
- Engaged with children on an individual basis pleasantly.
Claim Processor
Blue Cross Blue Shield/Tricare
Myrtle Beach, SC
02.2016 - 06.2017
- Utilized administrative guidelines as a resource or to answer questions when processing medical claims
- Paid or denied medical claims based upon established claims processing criteria
- Maintained learned knowledge of benefits claim processing, claims principles, medical terminology and procedures, and HIPAA regulations
- Consistently exceeded production standards.
Customer Service Representative
Blue Cross Blue Shield, PGBA, Veterans Choice
Myrtle Beach, SC
11.2015 - 02.2016
- Directed calls to appropriate individuals and departments
- Routinely answered provider and veteran questions regarding claims, authorizations, and referrals
- Politely assisted customers in person and via telephone.
Claims Customer, Advocate
Blue Cross Blue Shield, PGBA/Tricare
Myrtle Beach, SC
01.2013 - 11.2015
- Worked with medical review, appeals, utilization review, and claims departments to process claims
- Researched and updated claims for proper processing
- Responded to provider and beneficiary inquiries via letter and web response
- Consistently met production and received yearly raises as a result
- Worked off-site with little supervision
- Navigated multiple systems to process claims and forward medical records and appeals properly.
Certified Nursing Assistant
Home Health
Loris, SC
10.2010 - 04.2012
- Provided daily care for client at home
- Cooked meals
- Assisted with bathing
- Cleaned bathrooms, bedrooms, kitchen
- Washed laundry
- Assisted with medication (did tray weekly)
- Provided transportation to doctor and shopping.
Education
Associate of Applied Science - Early Care and Education
Horry-Georgetown Technical College
August 2021
Licensed in Nursing Assistant - undefined
Medical Training Center
May 2019
Completed requirements to receive Medical Billing and Coding Specialist Certification CPR Certified Nursing Assistant (CNA) -
Horry-Georgetown Technical College
Conway, SCFebruary 2018
CNA license -
Professional Medical Training Center
Conway, SCOctober 2011
Medical Billing & Coding
Horry-Georgetown Technical College
2011
Skills
- Powerpoint
- Microsoft word
- CPR
- Data Entry
- Health Insurance
- HIPAA
- Medical Records
- Medical Billing
- Medical Terminology
- Medical Coding
- Special education
- CPT coding
- Windows
- Mobile devices
- Typing
- ICD-9
- Microsoft Outlook
- Medicare
- HCPCS
- ICD coding
- Customer support
- Documentation review
- Doordash
- Delivery (1 year)
- Certifications and Licenses
- Certified Nursing Assistant
Additional Information
- Life and Health Insurance August 2021 to March 2025 I completed the requirement to receive a Life and Health Insurance License in August of the year 2021. Insurance Producer License August 2021 to March 2025 Accident & Health or Sickness, License
Timeline
Claims Processor II
Blue Cross Blue Shield
04.2022 - Current
Special Education Paraprofessional
Horry County Schools
04.2020 - 04.2022
Teacher Assistant
Waccamaw, EOC
01.2019 - 04.2020
After School Teacher
Horry County Schools
09.2017 - 03.2018
Claim Processor
Blue Cross Blue Shield/Tricare
02.2016 - 06.2017
Customer Service Representative
Blue Cross Blue Shield, PGBA, Veterans Choice
11.2015 - 02.2016
Claims Customer, Advocate
Blue Cross Blue Shield, PGBA/Tricare
01.2013 - 11.2015
Certified Nursing Assistant
Home Health
10.2010 - 04.2012
Associate of Applied Science - Early Care and Education
Horry-Georgetown Technical College
Licensed in Nursing Assistant - undefined
Medical Training Center
Completed requirements to receive Medical Billing and Coding Specialist Certification CPR Certified Nursing Assistant (CNA) -
Horry-Georgetown Technical College
CNA license -
Professional Medical Training Center
Medical Billing & Coding
Horry-Georgetown Technical College
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