Driven [Job Title] with [Number] years of Medicaid/Medicare claims for provider payments, paying close attention to details to avoid over and underpayments. Maintains production and claims quality of standards. Communicates with management regarding issues or trends in claims that could be considered fraud. Proofs claims for appropriate claim information regarding coding, member identification, diagnosis, services and correct provider information. Reviews Pharmacy/Medial claims in accordance with Medicare and Medicaid guidelines. Reviews eligibility and investigates benefits in accordance with Medical claim processing guidelines followed by adjudicating claim once everything has been verified. During my years with the company my skill includes scheduled appointments and travel arrangements for the director and Managers, setting up interviews, processing help desk tickets for the analysts to make repairs for the health plans. Back billed and processed payment for individual providers to balance books for the year. Prepared purchase order requests for the DPS department cell phones, ran daily, monthly and year-end reports. Experience offering personalized, courteous service.
Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.
Many factors go into creating a strong resume. Here are a few tweaks that could improve the score of this resume:
Job Titles Held: