Vicki Sharp
Claims Processor III
Detroit Lakes,MN
Summary
Results-driven Claims Processor III at CareFirst BCBS, adept at ensuring regulatory compliance and accuracy in claims review. Demonstrated critical thinking and professionalism while managing high volumes of claims, training new staff, and enhancing data integrity. Recognized for effectively resolving discrepancies, contributing to a streamlined claims process.
Overview
2026
2026
years of professional experience
Work History
Claims Processor III
CareFirst BCBS
2015 - 09.2025
- Processed insurance claims, ensuring compliance with company policies and procedures.
- Reviewed documentation for accuracy, identifying discrepancies to facilitate timely resolution.
- Assisted in gathering information from clients to support claims evaluations.
- Utilized claims processing software to input data and track claim statuses efficiently.
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Managed workload and priorities to meet claims processing meet deadlines.
- Trained new employees on claims processing procedures, contributing to a well-prepared workforce.
- Processed claims efficiently, ensuring accuracy and adherence to policies and procedures.
- Communicated effectively with members and providers to resolve claims inquiries and discrepancies.
- Assisted in training new staff on claims processing protocols and best practices for accuracy.
- Collaborated with cross-functional teams to resolve complex claims issues efficiently and effectively.
- Utilized specialized software to process incoming claims, enter data and generate reports.
- Utilized excellent analytical and problem-solving skills to quickly and accurately assess insurance claims.
- Maintained strict confidentiality when dealing with sensitive information about patients'' medical histories or personal details.
Education
Accounting And Finance
University of Phoenix
Tempe, AZSkills
- Claims review
- Accuracy and precision
- Transactions reconciliation
- Professionalism and ethics
- Regulatory compliance
- Data entry proficiency
- Critical evaluation
- Allocating claims
- Data entry
- Data integrity
- Critical thinking
- Claims adjustment
Timeline
Claims Processor III
CareFirst BCBS
2015 - 09.2025
Accounting And Finance
University of Phoenix
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