Medical High School

Joyce M. Brinkley

**** **. *** ****** *** Orleans, Louisiana 70119

Cell Phone: (504) 229 - 1847

*************@*****.***

OBJECTIVE

Seeking a position where my experience will be utilized. Experience in

Medical Claims Processing since 1990 and Class Action Claims Processing.

Have the ability to develop and maintain effective working relationship

with co-workers and management.

PROFESSIONAL EXPERIENCE

Lofton Staffing Services/Class Action Claims August 2013

Hammond, Louisiana

Claims Processor

. Responsible for interviewing and obtain information on claims. Linking

claimants information in computer such as submitting applications that

comes in. Correspond with internal staff in regards to claimants

documents.

. Review and verify data, such as name, address, Identification what

type of claims that's being submitted.

. Data entry of claims.

.

Arkansas Blue Cross Blue Shield March 2006 -

January 2011

Little Rock, Arkansas

Claims Examiner (Claims Specialist 10)

. Responsible for accurate and timely adjudication of medical claims.

. Responsible for additional investigation or communication in order to

obtain necessary information to complete the claim Code CPT and ICD-9

when needed.

. Provides complete and thorough file document recommendations, and

documentation.

. Performs claim file set up.

. Maintains workload inventory on a daily basis.

. Responsible for processing Hospital, Physician, DME, Ambulance,

Dental, Prescription,

Vision, VA and Foreign Travel Claims with edit/audit resolution and

determine eligibility and identify claims processing problems that may

occur.

Arkansas Blue Cross Blue Shield Temp October 2005 - March

2006

Little Rock, Arkansas

Incoming Verification Specialist

. Responsible for making decision as related inquiries received from

members and Providers

. Research problems, concerns or inquiries and provide appropriate

information to patients and providers.

. Ability to listen, comprehend what is said, be friendly and Courteous.

. Handle confidential information with integrity and professionalism.

. Perform Clerical and other duties as assigned within the department.

Gulf South Health Plan/Temp thru Keenan Staffing February 1997-

August 2005

Metairie, Louisiana

. Responsible for accurate and timely adjudication of medical claims

. Hospital, Physician, DME, Ambulance, Dental, Prescription, Vision and

VA Claims with edit/audit resolution, determine eligibility and

identify claims processing problems.

. Request authorization and ER report as needed.

. Code CPT and ICD-9 when needed.

. Write memos to providers, research claim problems and communicate

orally and written

. Handle confidential information with integrity and professionalism

with all guidelines.

.

EDUCATION

John McDonogh Senior High School 1971 - 1974

New Orleans, LA

SKILLS

Typing 50 wpm, Amisys System, Dakota System, AS400, File Net Capture,

Facet, Microsoft Word, Advanced Health Information Network (AHIN), Data

Entry, Internet and TPX System

Contact this candidate