desk adjuster resume example with 4+ years of experience
JessicaClaire
, , 609 Johnson Ave., 49204, Tulsa, OK100 Montgomery St. 10th Floor
H: (555) 432-1000
C:
resumesample@example.com
Date of Birth:
India:
:
single:
:
Summary
Exceptionally focused and meticulous seeking a position in the Medical Field with a painstaking eye for detail and a superior work ethic. Adept multitasker able to handle simultaneous institutional tasks with full professionalism and accuracy. Outstanding ability to maintain cordial and professional relationships with customers and supervisors.
Skills
Administrative support
MS Office
Proficient in 10 key and alpha/numeric data entry
Medical Terminology
Collecting payments
Claims review
Insurance verification
Paperwork management
Understanding of EOB's
Spreadsheets, Emails, Presentations/ Sideshows, Web
Thorough knowledge concerning patient confidentiality and HIPPA rules
Strong problem-solving and communication skills
Exceptional interpersonal and customer service skills
Excellent time management and organizational skills
Experience
Desk Adjuster, 04/2019 - 10/2019 Sedgwick Claims Management Services, Inc. – Pompano Beach, FL,
Analyzed first reports of loss and underlying file material to determine if claim was suspect.
Adhered to company and insurance client's guidelines in claims processes, estimate writing and claim closures.
Conducted interviews, gathered detailed information and completed field investigations.
Investigated potentially fraudulent claims with focus on thoroughness, quality and cost control.
Reduced loss ratios through fair and prompt processing of claims.
Worked with underwriting on loss reserves and risk assessment and coordinated field reviews.
Complied with company and insurance client's guidelines in claims processes, estimate writing and closing of claims.
Drafted statement of loss to summarize damages, payments and underlying policy coverage.
Use estimating software to establish indemnity values of claimed damages.
Investigated properties, classified damages and created estimates outlining repair costs.
Determined insurance coverage levels and restrictions by thoroughly examining claims forms and associated records.
Presented and clearly explained insurance policy options based on clients' needs and goals.
Processed applications, payments, corrections, endorsements and cancellations.
Performs various functions in the processing of insurance billing and collections, including Medicaid/Medicare claims according to the established policies and procedures as listed in the ACS Practice Management, Compliance and HIPAA Policies & Procedures Manuals. Many of ACS Clients' accounts require team effort while other accounts may require independent workers to complete all aspects of the billing process. Employees' may be responsible for multiple accounts with functions varying with each account. Assignment of accounts may fluctuate ACS Client base changes.
Collects and enters patient's insurance information into ACS CompuMed System. (Invision, Nextgen).
Reviews, verifies and submits insurance claims.
Processes correspondence from Third Party Payers and responds to patient requests.
Follows-up with insurance companies and ensures claims are paid in a timely manner.
Resubmits insurance claims that have received no response.
Answers telephones, provides and obtains information to resolve billing and collection issues.
Maintains supporting billing information for future reference or audit purposes.
Demonstrate competencies applicable to the job position while performing duties in a professional and courteous manner
Patient Relations Coordinator, 12/2014 - 09/2016 Hendrick Medical Center – Brownwood, TX,
Greet and check-in patients, and collect personal, medical, and insurance information.
Collected patient co-payments and recorded payment transactions; obtained third-party authorization for services provided and communicated outstanding balances to insure companies and patients.
Use EMR software to manage patient records and files( fax reports and scan documents); reinforce and uphold patient confidentially as required by HIPAA and clinic.
Answer incoming telephone calls, make copies, send faxes and handle all incoming and outgoing correspondence.
Other duties and responsibilities as assigned.
Education and Training
: Office Management, Expected in - Coastal Alabama Comm College - Bay Minette, AL, GPA: Status -
Word Processing
Personal Development
Business Communication
Fund Public Speaking
Medical Terminology
Spreadsheet Appls
Office Management
Certification : Certified Phlebotomy Tech, Expected in 03/2016 - Fortis College - Mobile,AL, GPA: Status -
High School Diploma: , Expected in 05/2014 - Ben C Rain High School - Mobile, AL GPA: Status -
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