Summary
Overview
Work History
Education
Skills
Timeline
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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, CA

Skills

  • 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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SHELBY PENDLETON