Customer Service Data Entry
Resume:
Jan Shope
***.*.*****@*****.***
PROFESSIONAL SUMMARY
Experienced Administrative Support professional with experience in medical insurance claim processing, credentialing. and billing. Skilled at providing customer service with problem solving and analytical skills to be effective in a variety of roles and fields, such as Law Offices, various County Departments, Court Clerk, Engineering firms, Mortgage brokers.
SKILLS
Knowledge of HIPAA and OSHA regulations/processes
Insurance verification and authorization
Patient billing: CMS-1500, UB-04
Coding: CPT, ICD-9, ICD-10, HCPCS
Data Entry
10-key
Extensive experience with a variety of insurance programs, including HMO’s, PPO’s, Medicaid, Medicare, Blue Cross/Blue Shield, TriCare & Champ VA
Customer Service
EDUCATION
Everest Institute
Austin, TX
Medical Billing & Coding Diploma
Sacramento State College
Sacramento, CA
General Studies
Piner High School
Santa Rosa, CA
H.S. Diploma
WORK HISTORY
Sutherland Healthcare
Pittsford, NY
Nov 2021 to Feb 2024
Medical Provider Credentialing
Programs Used: Citrex; CAQH; SmartCred; Cactus; Epics; BPM (process where documents are attached and stored that are required for completion of credentialing process); Microsoft Office. Attended Zoom and Microsoft Teams meetings with Sutherland team members in other states and other countries.
Burnett Staffing
Houston, TX
Nov 2020 to Feb 2021
CVS Speciality Medicines
Review Specialty Medicine Prescription Process
Burnett Staffing
Houston, TX
Jan 2020 to Sept 2020
Centene Corporation
Vertexer (data entry)
Responsible for entering medical claim data from incoming faxes from providers.
Austin Staffing Inc
Austin, TX
Aug 2019 to Oct 2019
IEnergizer
Data Entry Clerk
Responsibility with quality for information being submitted into company database, auditing for proper formatting and input accuracy.
Cross-referenced manually submitted data with source documents, and properly filing source documents once notation was finalized.
Nurse Next Door
Elgin, TX
Jan 2019 to Aug 2019
Personal Care Aide
Responsible for the daily care and safety of individuals with specialized care requirements.
Managed dietary needs and cleanliness of environment.
Leveraged relationship building skills to create a partnership with patients and family members.
Aerotek Staffing
Austin, TX
April 2017 to June 2018
Office Clerk
Medical Clerk responsible for initiating claim process, verifying accuracy of all information Provided.
Worked closely with Claim Review Team and following-up with closing documentation.
Office support Clerk coordinating the processing, sorting, and distribution of all incoming mail and packages from various postal providers.
Utilized Microsoft Excel regularly to track a variety of information.
Provided relief support for Switchboard Operator as needed.
Government Contractor
Austin TX
Oct 2014 to Feb 2017
General Clerk II Medical Claims
Started off working in the Immigration Department in medical claims and customer service, answering provider calls, and providing updated status on their claims.
Transitioned over to the Veteran’s Department.
Responsible for processing medical claims for the Department of Veterans Affairs Financial Service Center.
Experienced in registration process and creation of medical authorizations for eligible veteran’s healthcare needs.
Skilled in accurately distributing incoming medical claims for Choice Plan and VA Medical Plans in the department’s database.
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