Claims processor benefits specialist

Deja

EXPERIENCE

Detail-oriented Claims

Processor and Healthcare

Benefits Specialist with 5+

years of experience supporting

members in remote healthcare

environments. Skilled in claims

processing, benefits

administration, eligibility

verification, HIPAA compliance,

and account resolution. Proven

success meeting QA,

productivity, and customer

satisfaction metrics while

delivering exceptional member

support.

DISPATCHER (REMOTE)

Maintain accurate documentation and

records within CRM systems

Process service requests and update

customer information with a high level

of accuracy

Manage high-volume workloads while

meeting quality standards

AnswerNet -

WINFREE CHARTER ACADEMY

HIGH SCHOOL DIPLOMA

IRVING TEXAS

Feb 2026 -Present

PHARMACEUTICAL CLAIMS SPECIALIST

(REMOTE)

Everise - Jan 2025–Jan 2026

HEALTH BENEFITS CUSTOMER CARE

ASSOCIATE (REMOTE)

HealthEquity - Sep 2021–Dec 2024

SKILLS

• Claims Processing

• Medical & Pharmacy Claims

• HSA/FSA/HRA Administration

• Benefits Verification

• HIPAA Compliance

• CRM Systems

• Microsoft Teams

• Microsoft Outlook

• Zendesk

• Data Entry

• Quality Assurance

• Customer Service

*********@*****.***

469-***-****

Arlington, Texas

CONTACT

C L A I M S P R O C E S S O R

B E N E F I T S S P E C I A L I S T C U S T O M E R S U P P O R T P R O F E S S I O N A L

SUMMARY

Processed and reviewed high-volume

pharmacy claims

Resolved claim discrepancies through

research and coordination

Verified member eligibility, benefits,

and coverage information

Assisted members with HSA, FSA, HRA, and

COBRA accounts while providing claims and

benefits support.

Managed 50+ inbound calls daily while meeting

QA, productivity, and customer satisfaction

goals.

Resolved account and eligibility issues using

Salesforce, Outlook, Teams, and HIPAA-

compliant practices.

ODIS

EDUCATION

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