As a Medical Claims Processor I am responsible for making sure that each and every claim that i come across is paid or denied using the proper information, and also by verifying that all the information is accurate.
- Medical Claims Processor at Concentrix
- Second Assistant Manager at It's Fashion
- Server/Waitress at Waffle House
- Sales Associate at It's Fashion
8 months at this Job
- - Business Management
- High School Diploma
For my job as a medical claims processor I worked in a call center setting. While I worked each claim I was multitasking between multiple programs/applications. To be able to do this work you have to be fast paced but you must be efficient while doing so.
- Medical Claims Processor at WPS Health Solutions
- Account Manager/Customer Service at Aqua Finance Inc
- Customer Care Agent at Eastbay
- Sales Associate/Cashier at Great American Cookies
3 months at this Job
- High School Diploma
• Acted as a conduit between upper management and team members while fostering a positive relationship between the team, client and upper management.
• Researched and processes claims according to business regulation, internal standards and processing guidelines.
• Reviewed and verified Veterans' medical claims for accuracy.
• Verified the coding of procedure and diagnosis codes
• Assists the lead medical claims processor in training or mentoring new staff members
• Carried out the normal responsibilities of general clerks/medical claims processor, which include medical claims data entry, medical voucher examination and processing bulk claims for submission.
• Ensured claims are processed according to established quality and production standards
• Performed research on claim problems by utilizing approved policies, procedures, reference training materials, forms and coordinates with various internal support areas.
- Medical Claims Processor at ATP2-Dept. of Veterans Affairs
- Account Maintenance Rep at KForce-USAA
- Home Equity Account Specialist at KForce-USAA
- Loan Servicing Specialist II at Wells Fargo
1 year at this Job
- Bachelor of Business Administration - Health Services Administration
Responsibilities as a medical claims processor I managed insurance claims from patients in doctors' offices, insurance companies and hospitals. I analyzed and processed the insurance claim, checking it for validity. Compile, process, and maintain medical records of hospital and clinic patients in a manner consistent with medical, administrative, ethical, legal, and regulatory requirements of the health care system. Process, maintain, compile, and report patient information for health requirements and standards in a manner consistent with the healthcare industry's numerical coding system. Skills in being detail-oriented, strong customer service and people skills. Including patience, empathy and self-control, to deal with, emotional or frustrated clients.
Internal Medicine (IMA), Front Desk Receptionist
• Responsibilities as a medical office receptionist. I performed a number of duties, including greeting and scheduling patients for surgical and non-surgical appointments. Medical records, bookkeeping, medical coding, calling patients to remind them of appointments, handling billing, answering and routing calls, making transactions, and keeping paperwork organized. Trained in Epic and EMR with excellent organization skills.
- Medical claims Processor at Concentrix
- Medical Office Receptionist at Peace Medical Center
- Work Study Student Assistant/ Receptionist at GREENVILLE TECHNICAL COLLEGE
- Rehabilitation Technician at MAGNOLIA PLACE OF SPARTANBURG
3 years at this Job
Medical Claims Transaction Processor
- Medical Claims Processor at Conduent
- Auditor II at Precision Staffing for Galls LLC
- Order Processor at Remedy Staffing for Ledvance/Sylvania
- Order Processor/Customer Service at Remedy Staffing for Saddlecreek
5 months at this Job
- Associate - Fire and Science
The primary purpose of this position was to enter data from clinical billing reports into the Claims Processing System for all capitated accounts. This position was responsible for the accurate review of scanned documents to verify data from the original .pdf file, edit, input and process medical claims in accordance with regulations, standards and contractual obligations of the organization.
Specific Databases, Systems, Tools, and Programs Used:
● Proprietary software through American Specialty Health in Sorrento Valley
● MS Windows/MS Office
● OCR software
- Medical Claims Processor at Medical Professionals
- Database Analyst at HRIS
- Database Analyst/Programmer at State of Montana, Department of Environmental Quality
- Web Developer at Tony Acevedo Designs
3 months at this Job
- Associate of Applied Science - Programming
- Associate of Applied Science - Webmaster
Processed and adjust medical claims
- Medical Claims Processor at Delta Health Systems
- Medical Claims Processor at
13 years, 6 months at this Job
- High school - Office information systems
- Some college
Processed over 300 claims per week, check all bills for each Veteran to make sure they were authorized to receive care with providers outside fo the Veterans Medical Center. If the patient isn't authorized for care a letter for denial of care must be writtend and this information entered in our data base. All approved claims must be paid in a timely manner. To pay a claim I need to find the correct obligation number assigned to each type of authorization; we pay for general office visits to medical doctors, physical therapy bills, chiropratic care, mental health care, and other specialize care. I am required to open a batch number with the correct obligation numbers and then process each claim. Also I would prepare unauthorized emergency room visits and hospitalizations as a medical claim packet for our Clinical Director to review for approval. Each claim that is approved must be entered in a data base and then paid.
- Medical Claims Processor at VA Medical Centers
- Accounts Receivable Clerk & Co-Pay Cashier at VA Medical Centers
- Medial Support Clerk at VA Medical Clinic
- Medical Clerk at VA Medical Centers
5 years, 10 months at this Job
- Bachelor's of Liberal Arts & Bachelor's from The School of Social Work - Liberal Arts & Social Work
Claims processor, adjustor, auditing , pricing , processing complex high dollar claims, mentor, knowledge of hcpc codes/revenue codes/ diagnosis/knowledge of processing outpatient and inpatient claims/knowledge of coordination of benefits and Medicare
- Medical Claims Processor at Anthem Blue cross and Blue shield
20 years, 3 months at this Job
- - Medical assisting
3290 E Main Street Danville, IL 61832 United States From: 03/30/1998 To: 06/30/2017 Position Held: Medical Claims Processor/Examiner Duties, Accomplishments and Related
- Medical Claims Processor/Examiner at Health Care Service Corporation (BCBSIL)
19 years, 3 months at this Job
- - Fall Pharmacy Tech