Processing and adjudicating Aetna paper claims.
Maintaining integrity of claims receipts in accordance with standard claims operating and adjudication procedures.
● Accurately resolving pending claims using state and federal regulations and specific health plan criteria. Working within turnaround times to meet client performance guarantees for claims processing.
● Meeting productivity and accuracy standards.
- Claims Processor at Aetna Paper Claims Processor
- Night Auditor/Desk clerk at Motel 6
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2 years, 4 months at this Job
- B.S. in Business Administration - Business Administration
- AA - Liberal Arts
Remote claims processor
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I am a certified claims processor, i examine and process medical claims for a California based insurance called Medi-cal.
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Temporary contract. For Aerotek contact ended claims processor duties included talking with doctors nurses and customers viewed claims uploaded any new information needed files claims worked with computers fax Microsoft working in groups and part of a team.
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I am currently a claims processor at Signature Performance. I have numerous 10.0 in my QA audits, the quality of my work is something that I am very proud of.
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Claims Processor | Exxonmobil Corporation, Houston, TX
Risk management & Insurance Department
02/2018 to 09/2018
• Admin - Enter incoming Workers Compensation claims and manage existing claims; utilizing claims software ISO, Navrisk, EDI software for State reporting
• Assist with training of new software, Navrisk Vision; a team effort to train all departmemts involved with the daily fuctions of RM group
• Scheduling meetings, ordering lunch, processing paymemts, mail distribution, filing, data entry, create files, mail outs to claimants
• Payment processor for weekly and monthly workers Comp payments to claimants and all departmental payments. Ensure accuracy of all payment processing
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I was hired as a claims processor in May of 1991 but one of our big clients out of Nevada needed an "in house " representative so as I was an experienced and bilingual claims processor I was sent to Utah to establish an office. I was there for 5 years. I returned to the home office and joined the Audit Department, was an auditor for 2 years then went Nevada to establish an office for CNIC, was there for 5 years then returned to home office and was there til retiring on 2011. Being bilingual I was also giving seminars on Medical Benefits for CNIC.
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- High school
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