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Data Entry

Philadelphia, Pennsylvania, United States
December 01, 2017

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Kimberly Ruff

**** ********* **.

Philadelphia, Pa.19150

Cell# 215-***-****



Dependable team member who takes responsibility for personal work always accepting accountability for my decisions accomplishing goals. I am very punctual, conscientious and always reliable with a good attendance record. Work effectively as part of a team as well as individually accomplishing goals by building strong working relationships and willing to share knowledge, resources, and experiences throughout departmental and /or business unit boundaries. Customer focus is to demonstrate a commitment to internal and external customer satisfaction,meeting or exceeded expectations. Highly focused employee consistently getting results and managing competing demands on time.



CLAIMS ADJUSTER 11/1996 - 06/2015

Key Achievements:

• Extensive experience with various products – Plan to Plan, IPP/BlueCard, Out of Area accounts HCFA 1500 and UB92 1450 claim forms, Personal Choice, HMO, Foreign, Guest membership, Medicare 65 and employee claims, Coordination of benefits (COB), updated Medical records

●I have 19yrs of claims examiner data entry/processing and claims adjustments experience assisted in classroom training and chair side with employees within the claims department on Keystone Point of Service/HMO HCFA 1500, UB92 1450 claims processing and adjustments in regards to having excellent job performance as a claims adjuster I communicated with customers and employees with resolving claim rejections. I’ve reviewed/processed 70 or more claims per day across various lines of business for the organization investigated claim forms HCFA 1500 and UB92 1450 by verifying charges, member’s eligibility, authorizations rejection codes, documented findings and updated records on the Power MHS database. I’ve researched claim issues to ensure accurate and correct payments within a timely manner and reviewed member’s benefit package to ensure active coverage for services rendered performed other duties as assigned.

I am also familiar with HIPPA regulation policies when handling confidential information.


High School Graduate (June 1984)

Germantown High School, Philadelphia, PA

Technical Proficiencies: Power MHS database, HCFA 1500, UB92 1450 claim forms, Claims Inventory System, SLIQ, Mainframe, Value tech, Blue Square Database, IQ Plus, MS Windows and Planmate

• Recipient of Excellence of Award, Gold Coin and Spot award from 1997 to 2015 for exceeding production goals at Independence Blue Cross

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