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Additional Insurance Resume Samples
Claims Processor Resume Samples
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0-5 years of experience
- Determined if claim submission was completed correctly, verified data and entered into system for adjudication
- Worked directly with beneficiaries to resolve any errors and answer any questions regarding eligibility status
- Reviewed payments history to determine final payment amount, if any
- Translated foreign language claims into English utilizing translation software, then manually checked and coded appropriately
- Processed claims adjustments when applicable
10+ years of experience
- Provided independent decision making skills and demonstrated initiatives to resolve issues for internal and external customers
- Answered incoming calls while handling in-person inquiries
- Composed and typed routine letters and documented file activity on a regular basis on the computer
- Processed and handled new non technical claims
- Performed clerical functions which included opening, sorting and distributing incoming mail and processing outgoing mail, copy work, handled office subpoenas, filing and assisted the unit and supervisor in multiple projects using expert time management with little supervision
- Paid vendor statements and handled payment complaints and discrepancies
- Processed checks, stop payments, cancellations, voids and journal entry payments
- Scheduled appointments
0-5 years of experience
- Research and process claims according the processing guidelines and benefits
- Contact and follow up with members for additional correspondence
- Responsible for accurate and timely daily reports
- Assists with the training of new hires
- Third Party Administrator knowledge and experience
- Knowledge and use of ICD-9, ICD-10 and CPT coding
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[Claims Processor]
Last edited by: Gabriela Barcenas, CPRW, Content Writer II -
Gabriela Barcenas
CPRW, Content Writer IIGabriela is a Certified Professional Resume Writer (CPRW) and career adviser. With 10 years of digital media experience and five years of resume writing expertise, her publication history includes fashion, education, travel, social justice, equitable design and career advice.
