Sultan Shareef
ANAHEIM,CA
Summary
Experienced Claim Processor successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering 20+ years of experience and willingness to take on any challenge.
Overview
16
16
years of professional experience
Work History
Fact Finding Agent
Employment Development Department (EDD)
12.2021 - 02.2023
- Managed Unemployment Insurance (UI) claims sent from the State to research reasons for employment separations.
- Performed outbound calls to gather information from both the claimant and employer during the fact finding process.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Demonstrated the ability to manage a large case workload in a timely manner while making logical decisions on each case.
Intake Specialist
FedEx Ground
11.2020 - 02.2021
- Processed 50-70 intake forms per day for internal employees impacted by COVID-19.
- Created cases from a email queue of submitted claims and then transformed the information into a profile of COVID related cases.
- Attached medical documentations that have been received/updated to further process the cases.
- Operated and multi-tasked between a leave of absence software platform and HR system (Optis & Peoplesoft).
Claims Processor I
Beacon Health Options
05.2015 - 06.2020
- Data entry of 150-200 CMS 1500 & UB-04 claim forms per day.
- Adjudicated specialty claims including therapy, duplicate claims, reprocessed claims, in/outpatient, and home health care.
- Utilized special internal software such as Raintree & FlexCare to process incoming claims, enter data and generate reports.
- Assisted in special projects and resolved complex claim issues with providers over email.
Administrative Assistant
Spafax
10.2013 - 03.2015
- Assisted Metadata team with updating purchase orders and media files in company database.
- Interacted with movie distributors and airline clients contracted with Spafax.
- Provided clerical support to company employees by copying, faxing, and filing documents.
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
Operations Specialist
Bank Of America Corporation
05.2012 - 09.2013
- Processed wide variety of retail banking transactions for personal and commercial customers.
- Analyzed and closed out late customers' bank accounts and transferred the remaining funds to a beneficiary.
- Monitored accuracy of customer information in system.
- Reviewed error reports and entered the corrections in the system.
Medical Data Entry Processor
Kaiser Permanente
10.2011 - 04.2012
- Adjudicated claims including, coordination of benefits (COB), member liability denials, provider denials, and pending claims.
- Entered data into various computer systems accurately using Microsoft Office Suite.
- Located and corrected data entry errors and reported to management.
- Conducted audits of existing data entry processes.
- Reviewed and processed inbound faxes.
Medical Data Entry Specialist
WellPoint, Anthem Blue Cross
10.2010 - 04.2011
- Data entry entry of 150+ CMS 1500 forms per day.
- Coded inpatient, outpatient, and professional PPO/HMO medicare claims.
- Applied adjustments to members' accounts and performed follow-up phone calls for missing information.
- Maintained a spreadsheet of received and pending claims.
Accounts Receivable
United Healthcare
03.2007 - 01.2009
- Assisted claimants in resolving account balances, and performed collection follow-ups with payment arrangements.
- Answered 30+ inbound calls daily pertaining to reconciliation of delinquent accounts.
- Completed Physician claim forms with proper service and procedure codes for payment.
- Opened and sorted and distributed incoming correspondence, including faxes and email.
Education
Business Administration
Devry University
Long Beach, CAComputer Science And Programming
Fullerton College
Fullerton, CAHigh School Diploma -
Savanna High School
Anaheim, CA06.1997
Skills
- Strong Data Entry Skills/50 WPM
- 10-Key Touch
- Healthcare Experience
- Claims Processing
- Microsoft Office
- Office Administration
- Customer Service
- Time Management
- Multitasking
- Medical Terminology
Timeline
Fact Finding Agent
Employment Development Department (EDD)
12.2021 - 02.2023
Intake Specialist
FedEx Ground
11.2020 - 02.2021
Claims Processor I
Beacon Health Options
05.2015 - 06.2020
Administrative Assistant
Spafax
10.2013 - 03.2015
Operations Specialist
Bank Of America Corporation
05.2012 - 09.2013
Medical Data Entry Processor
Kaiser Permanente
10.2011 - 04.2012
Medical Data Entry Specialist
WellPoint, Anthem Blue Cross
10.2010 - 04.2011
Accounts Receivable
United Healthcare
03.2007 - 01.2009
Business Administration
Devry University
Computer Science And Programming
Fullerton College
High School Diploma -
Savanna High School
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