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Medical Insurance

Location:
Chicago, IL, 60660
Posted:
October 23, 2018

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Resume:

Maureen J. Galligan

**** ***** ******** ****; Chicago, Illinois 60660

312-***-**** email: *******@*****.***

Objective

With over 20 years of experience with analysis and payment of medical claims for a multi- employer benefit Fund, I am seeking a position with a company where my ability to learn quickly and adapt to new situations will help me grow as well as benefit my future employer. Experience

February 4, 1994 – December 29, 2016

Claims Processor Chicago Regional Council of Carpenters Welfare Fund Chicago, IL

Possess the ability to learn, understand, interpret and correctly apply Plan rules, provisions and regulations when adjudicating claims

Accurately and effectively communicate the Plan rules and regulations to others in a clear, concise, professional manner

Adjudicate claims using proper diagnostic and procedure codes in accordance with Plan rules

Perform various tasks related to adjudication of claims, including contacting or requesting additional information and documentation from participants, providers and other insurance carriers

Verify accuracy of data received and update the system accordingly

Identify and adjudicate claims requiring referral for adjustment, corrections, subrogation and document reason for action

Understand and apply coordination of benefit Plan provisions and adjudicate claims accordingly

Meet and usually exceed quality and production standards

Good verbal and written communication skills

Ability to multi-task and complete work accurately and on time under minimal supervision Awards & Acknowledgements

More than 20 years of excellent evaluations done monthly and yearly by department managers

Held in high regard by managers, supervisors and fellow co-workers 2

Education

Joliet West High School, Joliet, IL

Diploma received in 1979

Professional and personal references are available upon request.



Contact this candidate