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Medical Insurance

Location:
Indianapolis, Indiana, United States
Posted:
August 09, 2018

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Resume:

Sandra E. Palmer

**** ******** ***** ** *** A Indianapolis IN 46260 317-***-**** ac6l16@r.postjobfree.com Objective Looking for an employer with room for future expansion and growth as an employee. Desire the ability to share views and ideas to help achieve growth and profitability within and for the company. Ideal job will provide a healthy work environment filled with challenges, rewards, recognition, interaction and the ability to showcase ones talents.

Experience

5/14 – Current Medical Claims Analyst, Cooperative Managed Care Services Investigate, analyze, and determine the extent of insurance company's liability concerning personal, casualty, or property loss or damages, and attempt to effect settlement with claimants. Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information. Calculate benefit payments and approve payment of claims within a certain monetary limit. 10/01- Present Claims Processor II, WellPoint/Anthem BCBS Processed claim forms, adjudicated for allocation of deductibles, co-pays, co- insurance maximums and provider reimbursements.

Followed adjudication policies and procedures to ensure proper payment of claims.

Resolved issues resulting from claim adjustments and researched claim overpayment and requested funds.

02/99-08/01 Answer One Analyst CSA II, Bank One

Researched and advised financial and legal inquiries for top executives and all Bank One locations.

Assisted merchants with account set up on varied front end and back end combinations and varied vertical markets.

Provided telephone support and performed account analysis using varied systems and applications.

05/74-02/99 Clerk III, Consumer Loan Specialist, NBD Bank Processed direct and second mortgage loans.

Assisted in overseeing personnel on daily operations. Maintained customer base for consumer loans department Trained new personnel.

Education

1973 Roosevelt High School

References References are available upon request



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