Healthcare claims processor, well versed in health insurance statutes, regulations and practices. Expertise in quickly analyzing documents and data to determine eligibility and courses of action. Analytical and motivated with strong results focus and attention to detail. Proficient with various claims processing software packages with excellent data entry skills. Effective communication skills with medical groups, insurance companies, and customers that serve to lessen confusion surrounding the processing and status of the claim. Adept at multi-tasking and completing assignments within any and all deadlines.
Job Objective to obtain a Data Entry Operator position that fully utilizes my experience and abilities.
Remarkable experience in data entry(alpha and numeric)
Command of medical insurance claims laws
Customer Service, Auditing, Training, Analysis and Operations
Proficient with claim processing software
PWC Columbia, SC
Claims Processor & Data entry
Dec 2017 to March 2018
Process refunds/reinstatements/ rejections of insurance claims, running reports on a weekly and monthly basis.
Reviewed patient accounts and resolved them to a zero balance by researching, and investigating all outcomes.
Kept track of the inventory by reporting and sending weekly updates planned, prioritized, organized and completed work to meet established production goals or quotas.
Resolved customers issues in regards to the settlement of claims not limited to arranging rentals, and payment for damage.
Research disputed claims on caller’s behalf to assist in liability decision.
Remarkable experience in data entry (alpha and numeric)
Proficient in Microsoft Office products (Word Excel Access and Outlook), 10-key and Alphanumeric typing.
In-depth knowledge of entering data fields into computers in Windows processes typing Speed 15 to 20 words per minute
Remarkable skill in coding information into proper form for entry
Excellent data entry skills
Strong clerical and administrative skills
Ability to process high volume of data on-line accurately.
WNS Global Services Inc., Columbia, SC
Medical Claims Processor& Data entry
February 2016 to 2017
Inspect the proper allocation of deductibles, co-pays, co-insurance and reimbursements according to the documentation submitted by the claimant and healthcare providers.
Maintain contact with medical providers to determine accuracy of claims.
Meet with customers to discuss results of claims, explaining the process and outcome.
Research medical processing laws and regulations at both the State and Federal level.
File all medical claims electronically by entering the proper data into the computer in order to generate accurate reports.
Determine the proper amount of coverage and forward payments to medical providers or the claimant.
Identify problems, analyze the cause and effect and make recommendations for improvement.
Train new Medical Claims Processors in all aspects of the job.
Mainframe Screens, Excel, MS word,
Jewelry World, Columbia Mall, SC
January 2015 to January 2016
Manage the customer service department and all employees.
Create work schedules for employees to ensure adequate workers for all shifts
Interview and hire new employees for vacancies.
Work with accounting to ensure employee hours are recorded properly and wages paid promptly.
Train new employees in all company policies and procedures.
Resolve customer complaints.
MS Word, Excel, Internet Explorer 6/7/8/9/10, Mozilla Firefox 3.x, Chrome
The Gazette, Eau Claire Community Council, N Columbia, SC
Data Entry Operator & Client Relations
Jan 2014 to Dec 2014
Perform secretarial duties in support of the business procedures.
Accurately input data into a variety of computer programs.
Utilizing both written and verbal communication skills, provided a high level of Customer Service & Client Relations.
Answer phones and create notifications in the computer system.
Constant contact with internal staff and external customers.
Demonstrating flexibility and ability to learn quickly.
MS Word, Excel, Visio
GED at Rosen Wald Community Learning Center
Computer Science, Andhra University, India