Responsible Medical Claims Processor with strong attention to detail and juggles multiple tasks. A go-getter committed to handling claims expeditiously.
Overview
3
3
years of professional experience
Work History
Claims Examiner
Sutherland Global Service
02.2024 - Current
Handled sensitive information with discretion, ensuring confidentiality of personal and financial details for claimants throughout the claims examination process.
Utilized analytical skills to evaluate medical bills for accuracy and appropriateness of charges before approving payments as part of the claims process.
Participated in cross-functional team meetings to address organizational challenges related to claims management and develop solutions collaboratively.
Reduced claim processing time by implementing efficient workflow strategies and prioritizing tasks effectively.
Pharmacy Service Representative
Teleperformance
06.2023 - 02.2024
Take inbound calls and answer questions about medication delivery and scheduling medication delivery
Assisted customers in navigating insurance claims, resulting in fewer denials and improved coverage understanding.
Claims Technician
Kelly Services
06.2022 - 05.2023
Processed patient insurance
Performed data entry for patient records
Evaluated complex claims situations, providing expert guidance to support informed decision-making processes.
Customer Service Representative
Sykes Enterprises - Incorporated
09.2021 - 11.2021
Assisted customers with a warm and professional attitude
Processed orders
Assisted customers with questions
Interacted with customers through live chat
Kept records of customer complaints
Handled emails, inbound calls, and outbound calls
Booked appointments
Managed customer accounts
Handled billing issues and order inquiries
Education
High School Diploma -
Gilmer High School
Gilmer, TX
06.2010
Skills
Typing
Claims Processing
Verbal Communication
Data Verification
Medical Terminology
Insurance verification
Filing
Clerical experience
Organizational skills
Medical documentation
Medicare
Medical Records
Assessments
Customer service, Proficient, 03/01/23, Identifying and resolving common customer issues
Administrative assistant/receptionist, Proficient, 04/01/23, Using basic scheduling and organizational skills in an office setting
Verbal communication, Proficient, 04/01/23, Speaking clearly, correctly, and concisely
Protecting patient privacy, Proficient, 04/01/23, Understanding privacy rules and regulations associated with patient records
Medical receptionist skills, Proficient, 03/01/23, Managing physician schedules and maintaining accurate patient records
Call center customer service, Proficient, 04/01/23, Demonstrating customer service skills in a call center setting
Work style: Reliability, Proficient, 02/01/23, Tendency to be reliable, dependable, and act with integrity at work
Basic computer skills, Proficient, 04/01/23, Performing basic computer operations and troubleshooting common problems
Scheduling, Proficient, 06/01/23, Cross-referencing agendas and itineraries to avoid scheduling conflicts
Attention to detail, Proficient, 04/01/23, Identifying differences in materials, following instructions, and detecting details among distracting information
Workplace safety, Proficient, 03/01/23, Using safe practices at work
Medical billing, Proficient, 05/01/23, Understanding the procedures and forms used for medical billing
Case management & social work, Proficient, 03/01/23, Determining client needs, providing support resources, and collaborating with clients and multidisciplinary teams
Data entry: Attention to detail, Proficient, 03/01/23, Maintaining data integrity by detecting errors
Customer focus & orientation, Proficient, 03/01/23, Responding to customer situations with sensitivity
Medical billing, Proficient, 03/01/23, Understanding the procedures and forms used for medical billing