Data Entry Claims Adjuster
Resume:
Lucretia A. Dunnum
P. O. ******
Oklahoma City, OK 73172
*********@*****.***
OBJECTIVE:
Experienced document processor and health insurance claims adjuster seeking a position with a local or national client base.
EXPERIENCE:
TTEC, Unlicensed Property & Casualty Claims Adjuster
10/2021 - 05/2023
Investigate, evaluate, and adjust low to moderately complex claims presented by or against insureds to confirm coverage, and determine legal liability and equitably Settle/defend in compliance with all state regulatory requirements
Recognize life events, understand member's need, and provide advice to deliver appropriate solutions to the member
Provide claim service via to members and third-party customers
Partners with and/or directs vendors and internal business partners to facilitate claims
resolutions
Support workload surges and/or catastrophe operations as needed during catastrophic
events
Seek guidance from team members to resolve issues and identify appropriate issues for escalation
Contributes to business goals, performance metrics, and effectively uses tools &
technology
American Cancer Society, Data Associates
3/2017 – 5/2020
• Balanced payment transactions and performed data entry analysis for billing processes
• Processed and packaged remittance accounts in Retail and Wholesale Department
• Utilized mail opening equipment and computerized processing equipment
• Prepared general ledger cash entries and examined mail for correct information
• Screened checks for acceptable payee, signature, and correct amounts
• Produced reports detailing payment information using computer applications
• Scanned checks and documents into TMS 2011 using imaging equipment
Amazon OKC 5, Warehouse Associate
8/2017 – 3/2020
• Prepared and completed orders for delivery or pickup according to schedule
• Loaded, packed, wrapped, labeled, shipped, received, and processed warehouse stock products
• Ensured a safe working environment with optimized space utilization
• Maintained diary logs and inventory records
• Reported any discrepancies and collaborated with supervisors and coworkers
• Operated and maintained warehouse vehicles
• Followed quality service standards and complied with procedures, rules, and regulations
Lincare, Billing Specialist
3/2016 – 6/2016
• Reviewed physician's orders for compliance and keyed patient setups
• Updated client information and filed charts
• Handled accounts receivable sales and performed data entry
• Effectively communicated with physicians' offices regarding insurance information updates
• Loaded information into AS400
Intermedix, Data Entry Specialist
7/2015 – 10/2015
• Created patient accounts in the computer system for medical service billing
• Inputted patient information, insurance information, and medical coding data
• Entered accurate demographic, biographical, insurance, and coding information
• Utilized both hard copy and electronic medical charts
BOK Financial, Remittance Processor 1
1/2013 – 2/2015
• Balanced payment transactions and performed data entry analysis for billing processes
• Processed and packaged remittance accounts in Retail and Wholesale Department
• Utilized mail opening equipment and computerized processing equipment
• Prepared general ledger cash entries while examining mail for correct information
• Screened checks for acceptable payee, signature, and correct amounts
• Produced reports detailing payment information using computer applications
• Scanned checks and documents into TMS 2011 using imaging equipment
Coventry, Auditor Associate Claims Specialist
7/2006 – 9/2011
• Demonstrated data entry proficiency and maintained accuracy rating of 98%
• Communicated with medical providers to obtain claims information
• Verified provider's information and made necessary adjustments to improve accuracy
• Reviewed and adjusted health insurance plans
• Ensured accurate service and claim processing
Reserve National Insurance, Document Processor
3/2002 – 7/2005
• Confirmed eligibility of insured individuals and determined treatment appropriateness
• Processed an average of 700 claims per day, exceeding job criteria by 35%
• Recognized by management for outstanding quality and service-oriented work
• Composed client information, eligibility, and collection details using word processor
• Obtained required information from doctors, lawyers, and hospitals for eligibility determination
• Processed disability and death claims
QUALIFICATIONS:
Proficient in 10-key touch.
• Skilled in utilizing Data Distribution Management Software (DDMS) to create financial and data reports.
• Extensive experience in accounts payable and practical knowledge of accounts receivable.
• Successfully managed enrollments, payments, and analysis of health insurance.
• Reviewed and made adjustments to health insurance plans.
• Responsible for month-end closing, including generating relevant monthly reports for sales, inventory, accounts receivable, and accounts payable.
• Proficient in reconciling invoices, posting payments, and running check payments.
• Familiarity with microfilm/microfish, Xerox machines, billing statements, ledgers and distributions, filing, data entry, processing faxinations ER, monitoring inbound/outbound calls, and handling customer concerns.
• Knowledgeable in the application of state fee schedules/guidelines, rules, and regulations.
• Demonstrated a flexible and positive attitude, adapting to the needs of assignments.
• Strong team player mentality.
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