SHELBY PENDLETON
Citrus Heights,Ca
Summary
Highly dedicated individual, seeking professional employment with my knowledge in the medical field. From my dedication in medical school, as well as 12+ years of customer service and administrative experience. Looking at opportunities for growth and advancement that will allow me to use my education and experience.
Overview
3
3
years of professional experience
Work History
CLAIMS PROCESSOR/TEAM LEAD
CA EDD, MMC Group/Maximus
11.2021 - 03.2023
- Analyzing claim information to determine the cause of outstanding issues
- Assessing eligibility requirements based on UI Code, Policies, and Procedures
- Evaluating wage and earnings
- Communicating with claimants and employers by phone to obtain missing information
- Working with subject matter experts to gain further understanding of unique issues and how to address them
- Referring more complex issues to supervisor or tenured staff
- Helped manage a small team when supervisor requested
- Notating all contacts and actions taken on a claim clearly and thoroughly
- Demonstrating the ability to make timeline and logical decisions
- All other duties as assigned by management to support claim processing.
- Utilized specialized software to process incoming claims, enter data and generate reports.
- Managed workload and priorities to meet claims processing meet deadlines.
DATA ENTRY CLERK/RESULTING ANALYST
StemExpress
04.2020 - 11.2021
- Inputting high volumes of patient information
- Managed documents by organizing forms, making photocopies, filing records, preparing correspondence, and creating reports.
- Created spreadsheets for more efficient recordkeeping.
- Accounting projects for essential COVID19 patient records
- Answering phone calls regarding general questions, donor calls and itemized receipts
- Exporting and pulling billing daily
- Receiving and entering Covid samples from various locations into Polytech (LIS) and Epic
- Entered numerical data into databases with speed and accuracy using 10-key pad.
- Experience using EPIC healthcare systems.
- Completed data entry tasks with accuracy and efficiency.
- Organized, sorted, and checked input data against original documents.
- Entered data into various computer systems accurately using Microsoft Office Suite.
Education
Associate of Science - MEDICAL BILLING AND CODING
Heald College
Roseville, CASkills
- LEADERSHIP/TEAM LEADER
- KNOWLEDGEABLE IN MICROSOFT PROGRAMS
- 10 KEY AND DATA ENTRY
- COLD CALLING
- CUSTOMER SERVICE SKILLS
- QUICK LEARNER/ABILITY TO WORK UNDER PRESSURE
- MEDICAL OFFICE SYSTEMS/EPIC SYSTEM
- CLAIM PROCESSING AND INSURANCE VERIFICATION
- EXCELLENT ADMINISTRATIVE ABILITIES
- ICD-9, ICD-10,HIPAA
Timeline
CLAIMS PROCESSOR/TEAM LEAD
CA EDD, MMC Group/Maximus
11.2021 - 03.2023
DATA ENTRY CLERK/RESULTING ANALYST
StemExpress
04.2020 - 11.2021
Associate of Science - MEDICAL BILLING AND CODING
Heald College
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