Summary
Overview
Work History
Education
Skills
Timeline
Generic

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, IL

Skills

  • 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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Stephen Janusz