Sharonda Phillips
Katy,TX
Summary
Effective Medical Claims Processor with strong background building rapport with providers to discuss claim status or claim denials. Driven performer equipped to handle multiple administrative tasks effectively. Exemplary worker with highly investigative skills when processing claims.
Overview
20
20
years of professional experience
Work History
Claims Analyst III
Elevance Health
03.2012 - Current
- Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
- Paid or denied medical claims based upon established claims processing criteria.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Checked documentation for accuracy and validity on updated systems.
- Verified client information by analyzing existing evidence on file.
Cashier
Walmart
06.2011 - 03.2012
- Operated cash register for cash, check and credit card transactions with excellent accuracy levels.
- Worked flexible schedule and extra shifts to meet business needs.
- Restocked and organized merchandise in front lanes.
- Collected and authorized payments of guests.
- Maintained secure cash drawers, promptly resolving discrepancies in daily totals.
- Reconciled cash drawer at start and end of each shift, accounting for errors and resolving discrepancies.
Pharmacy Technician Trainee
We Care Pharmacy
01.2011 - 06.2011
- Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists.
- Counted, measured, and compounded medications following standard procedures.
- Reviewed and verified customer information and insurance provider information.
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Communicated with prescribers to verify medication dosages, refill authorizations and patient information.
- Maintained proper drug storage procedures, registries, and records for controlled drugs.
- Restocked automated medication dispensing equipment.
Store Manager
Dollar Financial Group Inc.
06.2002 - 02.2010
- Managed store employees successfully in fast-paced environment through proactive communication and positive feedback.
- Maximized sales and minimized shrinkage through excellent customer service and adherence to standard practices.
- Set effective store schedules based on forecasted customer levels, individual employee knowledge and service requirements.
- Approved regular payroll submissions for employees.
- Supervised guests at front counter, answering questions regarding products.
Education
No Degree - Elementary Education
University of Louisiana At Lafayette
Lafayette, LANo Degree - Business Management
University of Phoenix
Lafayette, LAHigh School Diploma -
Northside High School
Lafayette, LA05.1998
Skills
- Health Insurance Industry Knowledge
- HIPAA Procedures
- Reviewing Patient Information
- Critical Thinking
- Thorough Claims Reviews
- Verify Data
- Claim Validity Determination
- Medical Terminology
- Insurance Claims
- Electronic Claims Processing
- Organizational Policies
- Information Updates
Timeline
Claims Analyst III
Elevance Health
03.2012 - Current
Cashier
Walmart
06.2011 - 03.2012
Pharmacy Technician Trainee
We Care Pharmacy
01.2011 - 06.2011
Store Manager
Dollar Financial Group Inc.
06.2002 - 02.2010
No Degree - Elementary Education
University of Louisiana At Lafayette
No Degree - Business Management
University of Phoenix
High School Diploma -
Northside High School
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