Claims Processor Service Rep

Laura Hipp

219-***-**** ********@*****.*** **** W 2nd St Hobart, IN 46342

CAREER OBJECTIVE

I am seeking a challenging position within the company that will enable me to use my professional experience and knowledge that I have obtained. Adaptable professional with 20+ years of work experience and proven knowledge of problem-solving, and workflow prioritization. Aiming to leverage my abilities to successfully fill the Claim Processor role at your company

EXPERIENCE

CLAIMS SUPERVISOR, Chicago, IL

Evolent Healthcare, Valence Healthcare, June 2016-February 2023

•Conducted employee evaluations and documented overall progress

•Set performance goals for staff members and helped teams meet important deadlines

•Notified employees of policy and procedure changes to promote overall compliance

•Streamlined workflow processes to reduce costs and improve productivity

•Delegated tasks to team members according to individual strengths

CLAIMS TEAM LEAD, Chicago, IL

Evolent Healthcare, March 2014-June 2016

•Collaborated with other departments to ensure successful completion of projects

•Prepared and organized instructional manuals, learning aids and job aids

•Delegated tasks to team members according to project requirements and employee strengths

MEDICAL CLAIMS PROCESSOR, Chicago, IL

Evolent Healthcare, February 2011-March 2014

•Corrected processing errors by reprocessing, adjusting and recouping claims • Reported overpayments, underpayments and other irregularities

•Calculated amount of claim.

MEDICAL CLAIMS PROCESSOR

Benefit Administrative Systems, July 2009-July 2010

•Corrected processing errors by reprocessing, adjusting and recouping claims

•Reported overpayments, underpayments and other irregularities

•Calculated amount of claim

•Answered member and provider phone calls

MEDICAL CLAIM PROCESSOR

Aetna Healthcare, January 1999-December 2008

•Corrected processing errors by reprocessing, adjusting and recouping claims

•Reported overpayments, underpayments and other irregularities

•Calculated amount of claim

•Handled high dollar claims

MEDICAL CLAIM PROCESSOR/ CUSTOMER SERVICE REP Prudential Health Care, June 1985-December 1998

•Corrected processing errors by reprocessing, adjusting and recouping claims

•Reported overpayments, underpayments and other irregularities

•Calculated amount of claim

•Trainor for new claim processors

•Answered phone calls from members and providers and reprocessed according to policy

EDUCATION

COMPLETED COURSEWORK TOWARDS HIGH SCHOOL DIPLOMA

Merrillville High School

SKILLS

REFERENCES

References available upon request

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