ITS Claims Processor Resume Example

I have extensive experience with Facets as I have been processing Medicare 1500 claims since I started working for TMG in 2004.  In addition to processing clean claims received through Proclaim, I have also worked customer service routes, appeals, corrected claims, non-traditional, and MSP files for various clients including American Progressive, Unicare, Wellcare, Carillion, VNS, NHP, MAPD, Advantage and ABCBS. I have a strong familiarity with the CMS website as well as several local carrier sites as a result of my processing background.

Although my position initially was a medical coder for various provider specialties, I was also responsible for helping to  implement an electronic submission system for commercial and government insurance programs claim forms.  I was promoted to Office Supervisor after 3 years and had over 15 direct reports for which I handled job delegations, scheduling, and payroll.  I was responsible for meeting with clients regularly and providing accounts receivable reports on a monthly and annual basis.