Medical Claims Processor Resume Samples

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Medical Claims Processors handle insurance claims from patients and check their validity. The job duties of a Medical Claim Processor are validating insurance information, checking for missing data, analyzing medical documents and approving or denying payment to doctors. Top skills highlighted in Medical Claim Processor resumes are accuracy, attention to details, organizational skills, communication abilities, and computer competencies. No formal education is required for the role, and many resume samples display only a high school diploma

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1

Medical Claims Processor

Handled heavy flow of daily paperwork and data entry, processing over 75 claims per day.

  • Effectively communicated with and support sales, marketing and administrative teams.
  • Investigated and resolved customer inquiries and concerns in a timely and empathetic manner.
  • Managed a wide variety of customer service and administrative tasks to resolve customer issues quickly and efficiently.
  • Learned, referenced and applied product processing information.
Candidate Info
5
years in
workforce
9
months
at this job
College Preparatory
2

Medical Claims Processor

Processed automobile medical payment claims

  • Communicated and negotiated effectively with customers and vendors
  • Solved problems and conducted research
  • Created and maintained business relationships with medical providers
  • Worked as a team within the claims department and other groups
  • Supported Allstate's commitment to the highest ethical standards
Candidate Info
6
years in
workforce
1
year
at this job
CNA
Nursing
3

Customer Service Agent/medical Claims Processor

Handled high inbound call volume, 80/120 calls per day on average, on a consistent while displaying team work as needed to accomplish daily tasks.

  • Performed medical billing and adjustments for claims.
  • Assisted members, physicians and hospitals with queries and concerns on accounts.
  • Navigated through various databases and programs for updating and maintenance daily.
  • Daily follow-up on claims and correspondence.
  • Provided information to members on various benefit insurance packages offered.
  • Provided ICD-9 and diagnostic codes for claims and medical procedures.
  • Maintained, correlated and prepared medical records and files of members.
Candidate Info
13
years in
workforce
13
years
at this job
C
Microsoft Specialist
Sociology/human Services
4

Medical Claims Processor

Entered patient daily census report in Vision program for supervisor to review.

  • Contacted Department of Social Services and secondary insurances to verify patient eligibility.
  • Answered multi-line phone and directed calls to appropriate staff.
  • Faxed and scanned patient charts to supervisor for sign offs.
  • Completed patient registration, collected co-pays and entered charges in the Vision program.
Candidate Info
16
years in
workforce
4
months
at this job
C
Certificate
5

Medical Claims Processor

Entering and processing of claims with right adjudication in accordance to insurance policy terms and conditions.

  • Completion of assigned batches.
  • Maintain communication with providers for claim clarification.
  • Kept constant communication with IT for network issues.
  • Cross trained to work in different departments (process different states).
Candidate Info
10
years in
workforce
3
years
at this job
Computer Science

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