Data Entry Claims Analyst

Solonia F. Breaux

*** ******* **., ****** *******, LA 70726

Phone: 225-***-****

E-mail: *************@*****.***

Objectives

To explore employment opportunities with your company. The enclosed resume will furnish you with details concerning my experience, training, and capabilities.

Experience

Contractor Consulting Claim Analyst (04/ 15/ 2016

Jacobson Solution/ DST Healthcare

Process Medicaid/ Medicare claims and Hospital claims

Correct and adjust claims to pay correct benefits

Repricing claims for Medicaid allowed amount

Process Dura Medical, Drugs, Inpatient and Medical claims

Review for correct Authorization per claim

Coordination of Benefit with other provider carrier

Quality Control daily and Audit payment for correction

Process age spread worksheet using Excel

Administrative Assistance 4 (02/2016-04/13 16

Wes staff/ DOTD (Baton Rouge La)

Handle all incoming calls and forward to proper recipient

Check mail for Procurement Section in the undersecretary’s office

Mail out purchase orders and contracts to vendors

File on a regular basis for requisitions, vendor, personnel, accounting, and administrative

Type up all correspondence to be given to each section, copied and given to appropriate buyer

Mail out all Notice Bidders contract proposal

Work all sealed Bid or contract proposal when received from vendors

Processed all invoices and tear sheet that are received from the magazines

Prepared all letter for the newspaper ad

Update all spread sheet for vendor purpose

Keep log sheet on all incoming mailed received for the purchasing department

Record all invoice on an excel spreadsheet

Keep record of meeting that are held in board room

Update safety manual once a month

Claims Analyst (05/2012 – 11/02/2015

Deep Water Horizon (Hammond, LA) Garden City Group

Process incoming claims for the Deep Water Horizon BP Oil Spill using a specially designed web based system for the purposes of:

Identification of incoming documents

Data Entry of incoming documents

Linking appropriate documents to the correct claimant

Categorization of each page for proper legal verification

Submit daily spreadsheets for reporting to management

Attend weekly meetings regarding various department briefings and changes

Claims Analyst (05/2001 – 07/2011)

Jacobson Solutions Travel Temporary (Chicago, IL) Blue Cross Insurance of Texas, North Carolina,Louisville Kentucky and Maine

Travel from state to state getting insurance companies out of backlog

Processed medical claims for Blue Cross/Blue Shield

Claim Adjustment and audit claims that was paid to the providers

Processed Preauthorization and Referrals for medical claims

Work claims that was denied by insurance companies

Processed Outpatient, Inpatient, PT,OT,ST claims

Assistance in getting insurance companies out of backlog

Process Medicare and Medicaid, medical and Hospital claims’

Skills

30 years of experience in processing medical claims in the Healthcare field

Nasco, Rims, ITS Host Plan, Power MHS, AMISYS, AS400, Faucet, Pro Med, Vital Works, and Diamond, Citrix, Clarity, DST System, Medicaid, Hospital, Dura Medical and Medicare Advantage claims. Attend school for medical coding from 2016 to 2017 completed.

References

Sandra West 800-***-**** ext. 1714 Blue Cross/Blue Shield

Tiffany Austin 918-***-**** Jacobson Solution

Carnetha Bradford 972-***-**** United Health Care

Laura Smith 225-***-****

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