Senior Claims Analyst Resume

SUMMARY

To help others who are in need, through experience working with people from all types of cultures and through knowledge and conversation with people who are in need.

PROFESSIONAL EXPERIENCE

Confidential

Senior Claims Analyst

Responsibilities:

Reviews and processes insurance claims for complex accounts, high dollar amounts, intricate carrier contracts and specialized clinical departments.
Receives, researches, and resolves correspondence from all organizations and patients.
Identifies problems and inconsistencies utilizing management reports, researches problems, summarizes findings, and makes recommendations.

Confidential

Community Resource Liaison (intern)

Responsibilities:

Working directly with families as well as assisting the professionals who investigate and manage cases of alleged abuse.
Conducting needs assessments, assisting CPS with investigations and casework, assisting families applying for various state benefits
Conducting home visits, supervising court ordered parent/child visits, and working in a multi - disciplinary environment.

Confidential, Dallas, TX

Billing Specialist

Responsibilities:

Confidential, Dallas, TX

Medicare/Medicaid Appeals Specialist

Responsibilities:

Determined medical necessity for ambulance transports
Filled out patient surveys for repetitive patients, corrected ICD-9 coding errors
Worked Medicare and Medicaid electronic submission reports, appealed claims

Confidential, Richardson, TX

Claim Examiner III

Responsibilities:

Confidential, Dallas, TX

Vehicle Remarketing Clerk

Responsibilities: