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Medical Claims Processor Resume Example

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MEDICAL CLAIMS PROCESSOR
Professional Summary
Skills
    • Strong written and verbal communicator
    • Medical terminology knowledge
    • Strong Medical Claims Knowledge
    • Strong interpersonal skills
    • Courteous Demeanor
    •  Dependable
  • Patient
  • Creative problem solver
  • Goal oriented
  • Team Oriented
  • Flexible
  • Professional and mature
  • Positive and Encouraging
Work History
11/2014 to Current
Medical Claims ProcessorATP2 – VA FSC Austin, Texas
  • Precisely completed appropriate claims paperwork, documentation and system entry.
  • Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information.
  • Carefully researched appropriate Va records for specific dates of services and procedures.
  • Verified diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered.
  • Acquired authorizations for procedures and tests rendered by attending physicians.
  • Verified patients' eligibility and claims status.
01/2014 to 11/2014
National Certified Medical AssistantScott & White – South 31st Street Temple, Texas
  • Maintained accurate records of patient care, condition, progress and concerns.
  • Observed and documented patient status and reported patient complaints to the physician.
  • Monitored vital signs, such as blood pressure and pulse.
  • Read and recorded temperature, pulse and respiration.
  • Completed and submitted clinical documentation in accordance with agency guidelines.
  • Prepared patient rooms prior to their arrival.
  • Obtained information about clients' medical history, drug history, complaints and allergies.
  • Support duties for diagnostic and technical treatment procedures, such as setting up and operating special medical equipment and apparatus.
  • Performed clerical duties, such as word processing, data entry, answering phones and filing.
07/2003 to 05/2011
ParaprofessionalVidalia Heritage Academy – Vidalia, Georgia
  • Instructed up to 20  students individually and in groups.
  • Observed and assessed student performance and kept thorough records of progress.
  • Set up lesson materials, bulletin board displays and demonstrations.
  • Managed classrooms of 15 to 21  students during the absence of assigned teachers.
  • Promoted physical, mental and social development by implementing classroom games and outdoor recreational activities.
  • Implemented a variety of teaching methods such as lectures, discussions and demonstrations.
  • Adapted teaching methods and materials to meet students' varying needs and interests.
  • Established clear objectives for all lessons, units and projects.
  • Met regularly with parents and guardians to discuss children's progress.
  • Encouraged students to persevere with challenging tasks.
  • Observed and evaluated students' performance, behavior, social development and physical health.
  • Set and communicated ground rules for the classroom based on respect and personal responsibility.
  • Identified early signs of emotional, developmental and health problems in students and followed up with parents.
  • Supervised an average of 25 students in classrooms, halls, cafeterias, schoolyards and on field trips.
  • Tutored children individually and in small groups to help them with difficult subjects.
  • Planned and implemented creative lessons in accordance with district, county, state and federal guidelines.
  • Taught after-school  program.
  • Scheduled and held parent-teacher conferences to keep parents up-to-date on children's academic performance.
  • Created an enjoyable and interesting learning environment for 20 students each year.
  • Established positive relationships with students, parents, fellow teachers and school administrators.
  • Maintained accurate and complete records for 20  students.
  • Mentored and counseled students with adjustment and academic problems.
  • Collaborated with other staff members to plan and schedule lessons promoting learning and student engagement.
Education
1987
High School Diploma:
Reidsville High School - Reidsville, GA
Certifications

Central Texas College

May 2014

National Clinical Medical Assistant


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Resume Overview

Companies Worked For:

  • ATP2
  • Scott & White
  • Vidalia Heritage Academy

School Attended

  • Reidsville High School

Job Titles Held:

  • Medical Claims Processor
  • National Certified Medical Assistant
  • Paraprofessional

Degrees

  • High School Diploma :

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