Senior Claims Processor of medical, dental, vision claims

Karen S. Kay

**** ******** ****

Aurora, IL *****

Home Phone: 630-***-****, Cell Phone: 312-***-****

E-Mail: **********@*******.***

Senior Claims Processor/Benefit Analyst

Professional Experience

Cognizant (Trizetto Group)

Claims Examiner, Senior August 2006 to April 2017

1335 N Mill Street, Naperville, IL 60563

Processed medical, dental, vision and flexible spending claims

Maintained production standards and quality requirements

Consistently processed numerous clients and assisted other examiners with backlog situations

Benefit Systems and Services

Claims Processor, February 2002 to March 2006

760 Pasquinelli Drive, Westmont, Illinois

Processed medical, dental and vision claims on self funded accounts

Consistently exceeded minimum processing standards and quality requirements which qualified me to work from home.

Worked on an on-line system from home 3 to 4 days a week

Determined eligibility of claims processed according to plan specifications

October 1976 through December 2001

In addition to the experience listed above I was responsible for:

Correspondence for my customer base

Customer service issues and quoting benefits to participants and providers

Auditing, training of new adjusters and planning of work flow

Working specifically with Clients to promote a better understanding of self funded benefits, including installation of Self Funded Benefit Plans

Preparing coverage transmittals for claims service

Generating ID Cards

Producing Summary Plan Descriptions and Plan Documents

Communicating benefits to Excess Carriers

REFERENCES Available upon request

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