Stephen Janusz
Phoenix,AZ
Summary
Hardworking claims specialist with 30 years of hands-on experience. Superior understanding of reporting tools, including scorecards, graphs, and charts. Proficient in Excel. Comfortable collaborating with team members and working independently.
Overview
29
29
years of professional experience
Work History
Claims Specialist
Jacobson Group
Chicago , IL
05.2020 - Current
- Evaluated pending claims to identify and resolve coordination of benefits issues blocking auto-adjudication.
- Assisted in a large project of adding providers into the system for a company which had expanded into a new market.
Claims Production Specialist
Blue Cross Blue Shield of Arizona for Harte-Hanks
Phoenix, AZ
01.2008 - 01.2020
- Full responsibility for initiating, finalizing, and reporting all BlueCard rework projects including recoupments as indicated by SIU. Assisted Finance area with recoupments and adjustments due to provider notification of excess payment, retro-termination of member coverage, and home plan benefit readjudication.
Temporary Claims & Customer Service Representati
Jacobson Group
Chicago, IL
08.2006 - 01.2008
- Sent adjustment requests on misadjudicated claims for Medicare Advantage members.
- Handled a variety of member calls for state and municipal groups, including retirees
Temporary Claims Processor
Insurance Overload Staffing Systems
Chicago, IL
11.1994 - 02.2006
- Claims processing for a variety of short and long term assignments, including medical, dental, workers' compensation, and state Guaranty Association-responsible claims.
Education
Some College (No Degree) -
Northern Illinois University
Dekalb, ILSkills
- Compliance Management
- Insurance Knowledge
- Claims Processing
- Teamwork and Collaboration
- Data Entry
- Organizational Skills
- Adaptability
- Analytical Thinking
- Medical Terminology
- Proficient in Excel
- Secure Data Practices
- Understanding of Medical Terms
- Insurance Terminology
Timeline
Claims Specialist
Jacobson Group
05.2020 - Current
Claims Production Specialist
Blue Cross Blue Shield of Arizona for Harte-Hanks
01.2008 - 01.2020
Temporary Claims & Customer Service Representati
Jacobson Group
08.2006 - 01.2008
Temporary Claims Processor
Insurance Overload Staffing Systems
11.1994 - 02.2006
Some College (No Degree) -
Northern Illinois University
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