Claim Adjudicator, Claim Specialist, Medical VA

Verified

$5/hr

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Outline

Looking for Full-Time work (8 hours/day) at $5/hour

Bachelor's Degree

English proficiency Conversational

Professional Summary

I describe myself as passionate and enthusiastic, I focused on my work in order to meet or provide the productivity being asked. I am keen to detail.

Skills & Experience

Skills

Problem Solving and Critical Thinking 5-10 Years

Accounting > Claims Processing 1-2 Years

Office and Administration > Microsoft Excel 5-10 Years

Professional Services > Management Services > Call Center Operations Management Less than 6 Months

Scheduling appointments 6 Months to 1 Year

Experience highlights

Claim Adjudicator

EXL · November/2022 – Present

Verifying patient’s eligibility;
• Reviewing the claim filed by an insurance holder;
• Provide specific benefits based on their claim form and
medical documents;
• Processing payments for healthcare providers, ensuring
accurate claim submissions and patient payments.
• Creating and sending a letter of Explanation of Benefits to the
insurance holder;
• Making an outbound call to the medical provider and
hospitals to verify date and type of services;
• Knowledge about ICD-10, HCPCS, CPT code.
• St

Customer Service Representative

Everise · August/2021 – Present

• Answering call from insurance holder;
• Provide accurate answer to customer’s inquiry
regarding on their insurance;
• Contributesto team effort by accomplishing related
results as needed;
• Communicating and coordinating with colleagues as necessary;
• Providing feedback on the efficiency of the
customerservice process;
• Document the problem, action and the resolution
given to the customer.

Store Supervisor

The Generics Pharmacy · February/2014 – Present

Conducting inventory counting ever months;
• Checking and making sales report using MS Excel;
• Work with manager and owner for the better sales
gross every month;
• Encoding of items in POS;
• Preparing purchasing orders using Microsoft excel;
* Knowledge about generic drug medicine and counter part to branded medecine.

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