Results-driven professional with strong skills in claims processing and insurance verification. Known for effective problem-solving and excellent customer service, consistently delivering timely results and ensuring compliance with industry regulations.
Overview
19
19
years of professional experience
Work History
Delivery Driver
Capital Trans Express
Groveport
08.2018 - Current
Delivered packages across designated routes, ensuring timely arrivals and customer satisfaction.
Adhered to traffic laws and safety regulations consistently.
Provided friendly, responsive customer service during package deliveries, enhancing customer experience.
Managed time effectively to consistently meet delivery schedules, optimizing route efficiency.
Delivered goods in a timely fashion while adhering to speed limits and other traffic regulations.
PROVIDER ADJUSTER
Anthem Blue Cross Blue Sheild
Columbus
04.2007 - 08.2018
Evaluated insurance claims to determine coverage and validity.
Collaborated with healthcare providers to obtain documentation supporting claims determinations.
Investigated claims for potential fraud or discrepancies.
Calculated and authorized payment of claims within designated authority level.
Reviewed policies to assess coverage levels and facilitated approval or denial of claims.
Reviewed medical coding guidelines to ensure accurate classification of diagnoses and treatments for patients.
Analyzed patient records and medical coding data to verify accuracy for reimbursement from insurance companies.