Sandra Whitten
San Angelo,TX
Summary
Results-driven Claims Processor at Kelly Services with expertise in claims management and data verification. Demonstrated critical thinking and attention to detail while resolving discrepancies and ensuring compliance with regulations. Proven ability to enhance workflow efficiency and maintain confidentiality, contributing to a streamlined claims processing environment.
Overview
1
1
year of professional experience
1
1
Certification
Work History
Claims Processor
Kelly Services
Troy, MI
11.2024 - 07.2025
- Processed insurance claims by reviewing documentation and verifying information.
- Utilized claims management software to track and organize claim files efficiently.
- Collaborated with team members to ensure timely processing of claims.
- Resolved discrepancies in claims by researching and analyzing relevant data.
- Verified claim data correctness in preparation for processing.
- Adhered to all applicable laws, regulations, and company standards while processing claims.
- Analyzed and evaluated claim forms, medical reports, bills, and other documents to ensure accuracy of data.
- Documented decisions on each claim based on research findings and applicable benefit plans.
- Identified trends in denials or rejections due to incorrect coding or billing practices by providers.
- Researched discrepancies between submitted documentation and actual records to identify errors or omissions.
- Corresponded with providers regarding any missing or incomplete documentation needed for successful adjudication of claims.
- Utilized claims processing software to streamline workflow and increase efficiency.
- Maintained confidentiality of policyholder information in compliance with HIPAA regulations.
- Adhered to state and federal regulations regarding insurance claims processing.
Education
High School Diploma -
McLane High School
Fresno, CA06-1991
Skills
- Claims processing and management
- Data verification and entry
- Attention to detail
- Critical thinking skills
- Team collaboration
- Confidentiality and ethics
- Multitasking ability
- Documentation accuracy
- Coverage determination
- Data management
Certification
- BLS Certification
Timeline
Claims Processor
Kelly Services
11.2024 - 07.2025
High School Diploma -
McLane High School
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