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medical claims analyst resume example with 9+ years of experience

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Jessica Claire
, , 100 Montgomery St. 10th Floor (555) 432-1000, resumesample@example.com
Professional Summary

Effective Medical Claims Processor with strong background building rapport with providers to discuss claim status or claim denials. Driven performer equipped to handle multiple administrative tasks effectively. Exemplary worker with highly investigative skills when processing claims. Highly trained professional with a background in verifying insurance benefits and creating appropriate patient documentation. An established Insurance Verification Specialist known for handling various office tasks with undeniable ease. Specialized in Medicare, Medicaid, Commercial, Hospice, Car Insurance, and Worker's Compensation insurances. Specialized in ER, Specialty, oncology, PT, OT, BH types of medical claims.

Skills
  • Insurance claims processing
  • Medical terms and procedure knowledge
  • Knowledgeable in word doc and excel
  • Telephone etiquette
  • Thorough claims reviews
  • Health insurance industry knowledge
  • Data security procedures
  • Understanding of medical terms
  • Prior authorization processing
  • Documentation abilities
  • Reporting skills
  • Data integrity
  • Excellent administrative abilities
  • Patient contact
  • Insurance coverage verification
Work History
09/XXX to Current Medical Claims Analyst Chubb | Urbandale, IA,
  • Managed large volume of medical claims on daily basis.
  • Reported policy changes and company conditions affecting customer satisfaction.
  • Reviewed provider coding information to report services and verify correctness.
  • Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
  • Used administrative guidelines as resource or to answer questions when processing medical claims.
  • Responded to correspondence from insurance companies.
  • Verified client information by analyzing existing evidence on file.
  • Communicated verification and authorization status updates with authorization department to facilitate decision-making for patient admissions and insurance coverage.
  • Maintained confidentiality of patient finances, records and health statuses.
  • Made contact with insurance carriers to discuss policies and individual patient benefits.
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
  • Reviewed 200 patient cases per week and verified insurance coverage information.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
08/2015 to 09/XXX Chef Manager American Dining Creations | Watertown, NY,
  • Placed food orders with suppliers on weekly basis, taking into account kitchen budget and expected demands.
  • Maintained high food quality standards by checking delivery contents to verify product quality and quantity.
  • Scheduled and received food and beverage deliveries, adhering to food cost and budget.
  • Disciplined and dedicated to meeting high-quality standards.
  • Developed and remained accountable for safety, quality, consistency and adherence to standards.
  • Inspected kitchens to observe food preparation quality and service, food appearance and cleanliness of production and service areas.
  • Oversaw scheduling, inventory management and supply ordering to maintain fully stocked kitchen.
  • Monitored and controlled overhead and production costs with responsibility for profit and loss.
05/2012 to 08/2015 Car Sales Associate Autosource Motors | Woods Cross, UT,
  • Conducted daily and weekly sales meetings to develop viable sales forecasts and associated sales strategies.
  • Drove team revenue totals by bringing in top sales numbers.
  • Located desired vehicles at auctions and other dealerships.
  • Established and devised strategy to meet personal goals consistent with dealership standards of productivity.
  • Greeted customers on lot and in showroom to answer questions about brand and available inventory.
  • Reviewed vehicles before final delivery to validate for completed tasks such as installed add-ons and damage corrections.
  • Demonstrated automobiles by explaining characteristics, capabilities and features, taking test drives and explaining warranties and services.
  • Prepared purchased vehicles and completed final delivery checks.
  • Met customers on lot and in showroom to discuss available vehicles and options.
  • Responded to customer enquiries via telephone and email.
  • Maintained compliance with all service, quality, and regulatory standards.
  • Followed-up on warm Internet leads and responded to customer questions about vehicle availability, price and options while fielding inquiries from various marketing websites.
  • Answered telephone and email inquiries from potential customers.
  • Outlined sales, warranty and service procedures.
  • Tracked down hard-to-find merchandise at diverse locations.
Education
Expected in 10/2004 to to | Law Enforement Okaloosa-Walton Community College, Fort Walton Beach, FL, GPA:

Attended the police academy and earned certificate of completion. Studied Law, interpersonal skills I & II, legal I, II, III, CPR, driving school and weapons. Was part of the explorer's program as a volunteer police officer for the Sheriff's Department while attending college.

Expected in 05/2000 to to High School Diploma | Centennial High School, Franklin, TN GPA:

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Resume Overview

School Attended

  • Okaloosa-Walton Community College
  • Centennial High School

Job Titles Held:

  • Medical Claims Analyst
  • Chef Manager
  • Car Sales Associate

Degrees

  • High School Diploma

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