Nursing Assistant Medical

Professional Summary

Skills

Work History

S H - L

***** **** **** **** **** Apt. 516, Southfield, MI 48075 • Cell: 248-***-**** • ******.****.*******@*****.*** I bring with me over 30 years of experience working with medical claims from opening mail to loading benefits. I am a good dependable worker always willing to learn more as well as share what I have learned over the years with others.

Knowledge of medical terminology, ICD-9,

ICD-10, CPT, HCPCS

Excellent written, verbal and leadership skills

Extensive claims knowledge

Word, Excel, Outlook

Strong analytical skills

Ability to work independently as well as in a

group setting

Analyst - Retired, 08/2009 to 05/2017

Blue Cross Blue Shield of Michigan – Detroit, MI

Analyze benefits for new products and load to the Local and Nasco systems. Update the system with any benefit changes.

Monitor the inquiry mailbox on a daily basis for problems identified by other departments. Investigate system issues and create IM ticket if needed to resolve. Participate in system testing and provide recommendations for the ongoing improvement of the updated process.

Represent the department as requested on workgroups and special assignments. Provide leadership with the status of projects and issues on a daily basis. All other duties as assigned.

Claims Processor/Pricer, 01/1988 to 08/2009

Blue Cross Blue Shield of Michigan – Detroit, MI

Process Local and Bluecard medical claims on a daily basis. Review paid/disputed claims for payment issues and possible adjustments. Communicate with other Blue Cross plans regarding home and host claims. Assist other areas and answer questions related to Bluecard claims. Education

Assist team leaders and other processors as needed. GED: 1980

Kettering High School Detroit - Detroit

Certificate: Accounting, 1981

Detroit Business Institute - Detroit

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