Data Entry Claims Processor

Shirley Smith

**** ** **** ******,******** City,OK 73118

Home:405-***-****/Cell:405-***-****

************@*****.***

SUMMARY OF QUALIFICATIONS:

Administrative professional with 20+years’ experience multitasking,analyze data,claims,and state of affairs,field incoming and outgoing communications,and complete tasks with multiple software systems and office machines.Ability to meet the needs of internal and external customers. SOFTWARE APPLICATIONS &PROFICIENCIES:

● Microsoft Office Suite ● Customer Relations ● Insurance Claims

● Typing Speed 60 wpm

● 10-key by touch

● Inventory Control

● Bookkeeping

● Claims Auditing/Processing

● Knowledge of various

● Claims Applications/Software

● Multi-Telephone lines

● Data Entry

Claims Applications

EDUCATION:

Bachelors of Science/Business Management -7/2016

Everest University

Associates of Science/Business Administration – 7/2014 Everest University

Unit Clerk Certificate – 6/1977

Oklahoma Skilled Center

WORK HISTORY:

Acordia Benefits Insurance Company,Austin,TX 1992-1998 Claims Supervisor

Supervised up to 20 employees in the claims processing and auditing departments

Developed skills,improved performance,and encouraged professional growth through effective training,coaching,and feedback

Established partnerships with internal &external departments to ensure accuracy and customer satisfaction

Updated procedural codes within company database for correct payment or denial of client benefit package

Auditor

Conducted daily review of pending claims and prepared weekly audits for each claim

Contributed to the development of claims analysis reports

Ensured that denied and underpaid claims were timely reprocessed Claims Processor

Managed all health and dental claims for payment or denial according to benefits package

Communicated via telephone,mailings or emails with outside sources to obtain additional information needed to process claims

Maintained and preserved confidential aspect of claim information effectually Hertz HCM Insurance,Oklahoma City,OK 1989-1992

Claims Processor

Administered all health and dental claims for the entire state of Oklahoma by reviewing the customer’s policy in relation to the claim being made

Effectively communicated with clients to provide and obtain updates on claim status

Liable for meetings all production quotas

Global Life Insurance,Oklahoma City,OK 1983– 1989

Claims Processor

Processed all health and dental insurance claims for the entire state of Oklahoma

Determined coverage,if any,and the impact on the future coverage of the client

Investigated claims to ensure complete accuracy and honesty

Collaborated with claim underwriters and various departmental leads to assure company compliance and regulations were upheld

Accountable for meeting all production quotas

St.Anthony Hospital,Oklahoma City,OK

Unit Clerk (Alcohol Treatment Center) 1977–1983

Greeted residents and visitors in a friendly,courteous manner

Coordinated admission and check out of residents

Collected copayments and verified insurance coverage

Monitored accurateness,suitability,and totality of patent accounts

Answered telephones,documented messages,and directed calls to recipients Additional work experiences’ held through Link Staffing Services.

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