Claims processor

Professional Claims Analyst with a track record of enhancing claims management efficiency at EPIQ SYSTEMS, INC. by implementing innovative systems, improving data accuracy by 30%. Expert in HIPAA compliance, demonstrating exceptional attention to detail and a positive attitude. Proven ability to streamline workflows and foster cross-functional collaboration. CLAIMS TEAM LEADER — EPIQ SYSTEMS, INC.

Phoenix, Arizona, October 2021 - October 2024

MEDICAL CLAIMS ANALYST — Cognizant Technologies Solutions Phoenix, Arizona, June 2017 - September 2021

Jessica Dean

Phone 602-***-****

Email ************@*****.***

Address Phoenix, AZ 85007

• HIPAA Compliance • UB-04, CMS 1500

Dynamic, GenNext, EZCAP, CMX, and Facilitator

Systems

• • Proficiency in SAP and CRM Software

• Microsoft • Attention to detail

• Time management • Workload balancing

• Payment Processing • Friendly, positive attitude

• Strong analytical skills • Data Logging

• Implemented a new claims management system, resulting in improved data accuracy and processing times.

• Collaborated with other departments to improve overall company performance in claims handling.

• Assisted with day-to-day operations, working efficiently and productively with all team members. Served as a liaison between the help desk team and other departments, fostering better cross-functional collaboration for seamless operations.

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Performed additional administrative tasks as needed, including data entry and report generation for internal review, and external audits.

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Ensured accurate payments by meticulously reviewing Electronic medical records, invoices, and supporting documentation, paying or denying over 60 medical claims based on membership eligibility daily.

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• Prepared denial approval letters as well as enrollment letters and changes in coverage. Review the member's out-of-pocket costs for the correct cost-share application, and COB information, and apply it accordingly.

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• Analyze and adjust claims as needed using the Facets system to adjudicate claims.

• Conducted comprehensive audits to identify inconsistencies and irregularities in medical claims data. PROFESSIONAL SUMMARY

SKILLS

EXPERIENCE

DOCUMENT PROCESSOR — JP Morgan Chase

Tempe, Arizona, July 2015 - March 2017

MEDICAL BILLING & CODING IN HEALTH ADMINISTRATION

— Coding Clarified

Mesa, AZ, Nov 2022

HIGH SCHOOL DIPLOMA

— Compadre Academy

Tempe. AZ, Jan 2015

• Enhanced claims processing efficiency by streamlining workflows and optimizing data entry procedures.

• Assisted with 80+ inbound and outbound document processes, sorting, logging, and creating work orders:

• Maintained physical and computer-based filing systems.

• Responded to internal and external requests for information.

• Recreated claims regarding missing or needed information.

• Facilitated organized record retrieval and access by maintaining a filing system for in-house and discharged residents. EDUCATION

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