claims specialist resume example with 7+ years of experience
JessicaClaire
, , 100 Montgomery St. 10th Floor(555) 432-1000, resumesample@example.com
Summary
Meticulous and systematic Administrative Assistant skilled in organizing, planning and managing daily clerical needs. Bringing solid expertise in coordinating documents, reports and records, handling correspondence and managing deliveries. Skilled in oral and written communication, team leadership and relationship-building.
Skills
Documentation Review
Information Verification
Customer Service
Problem-Solving
Data Entry
New Policies Processing
Verbal and Written Communication
Data Entry Software
Policy and Procedure Explanations
Decision Making
Schedule Management
Critical Thinking
Travel Administration
Timeline Planning and Management
Excel Spreadsheets
Experience
11/2020 to CurrentClaims SpecialistHighmark Inc. | Natrona Heights, PA,
Investigated and analyzed requirements to improve timeliness of reports to customers.
Processed weekly claims daily and expertly handled as many as 20 calls with impeccable quality.
Reviewed documentation and accounts to gain full picture.
Supported efficient handling of complex claims and followed up on open, denied or suspended claims to complete required line items.
Delivered quality customer service to assigned, insured and claimants throughout entire claims process.
Promoted agency products to customers in person, by telephone.
06/2018 to 10/2020Advanced Medical Support AssistantDepartment Of Veterans Affairs | Little Rock, AR,
Updated outdated patient information to maintain current records.
Retrieved patient files for doctors.
Scheduled approximately 20 appointments daily for Eye & Dental.
Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment.
Scheduled appointments for patients via phone and in person.
Organized charts, documents and supplies to maintain team productivity.
Contacted pharmacies to submit and refill patients' prescriptions.
Secured patient information and maintained patient confidence by completing and safeguarding medical records.
Conducted insurance verification and pre-certification and pre-authorization functions.
Followed principles of asepsis and infection control to meet patient safety guidelines.
Responded to patient callbacks and phone-in prescription refill requests.
Documented notes during patient visits.
Incorporated outside records into charts and EHR.
Distributed treatment and procedural information to patients.
Gathered current medical information and reviewed histories to gather details for surgeons.
Booked surgeries according to physician volume and maintained prompt turnaround times.
Scheduled follow-up appointments as designated by physician.
Checked physician orders and schedule availability to make accurate appointments for tests and surgical procedures.
Conveyed information to patients about arrival times and preoperative procedures.
Organized patient medical records and worked with insurance company representatives to obtain authorization.
08/2014 to 06/2018Medical Assistant/Administrative AssistantKenton Family Care Primary /Kenmore Mercy Hospital | City, STATE,
Answered phone calls to provide assistance, information and medical personnel access.
Scheduled and confirmed patient appointments for diagnostic, surgical and consultation services.
Updated patient accounts and information daily.
Scheduled patient appointments, accounting for physician availability and optimal patient loads.
Managed physician calendar, scheduling patient appointments and procedures.
Scheduled radiology exams for patients.
Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment.
Interviewed and engaged patients to obtain medical history, chief complaints and vital signs.
Prepared treatment rooms for patients by cleaning surfaces and restocking supplies.
Educated patients about medications, procedures and physician's instructions.
Organized charts, documents and supplies to maintain team productivity.
Contacted pharmacies to submit and refill patients' prescriptions.
Secured patient information and maintained patient confidence by completing and safeguarding medical records.
Assessed, documented and monitored vital signs for patients within outpatient setting.
Cleaned and maintained medical equipment following procedures and standards.
Documented notes during patient visits.
Labeled and completed lab requisitions using ICD and CPT coding.
Worked with operating facilities to schedule procedures on behalf of surgeons.
Gathered current medical information and reviewed histories to gather details for surgeons.
Distributed treatment and procedural information to patients.
Education and Training
Expected in 05/2013 to to Associate of Applied Science | Bryant And Stratton College, Getzville, NYGPA:
Dual Associate Degree
Medical Assistant / Medical Administration
Expected in 06/1981 to to High School Diploma | Sweet Home Senior High School, Amherst, NYGPA:
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