Clerical Assistant Resume Jackson, Ms - Hire IT People

Qualification Summary

9 years of proven experience in the clerical field, 13 years of claims adjudicator and claims adjustments
Excellent oral and written communication skills, able to maintain high levels of professionalism at all time.
Self motivated and able to work both independently and in a team environment. Capable of making sound decisions and judgements in areas of perceived difficulty.

Employment

Confidential, 1997- Present

Handles adjustments of claims for Local business, validates, research and investigates inquries from Providers, subscribers, and Plan personnel requesting adjustments or recovery of an overpayment. Makes logical benefits and claims adjustment decisions involving coordination of benefits. Ensures proper credits or debits are related in claim history. Reviews balance an modifies accounting reports and check reconciliation reports based on activities of the Adjustment Department. Handles mail system generated letter to secure additional information for adjustment of a claim and composes letter when necessary. Handles all correspondence regarding adjustment inquiries. Makes telephone calls or personal contact by subscribers or providers regarding recovery activity. Answers questions and/or assists co-workers with adjustments. Ensures accurate assignment of ICD-9 and CPT-4 codes to multiple surgery, surgery, anesthesia, assistant surgery, pharmacy, x-ray, medicine and laboratory claim, Enter coded data on computer.

Clerical Assistant 1988-1997

Supply records for Physician Reviewers, main tickler files, matched correspondence to appropriate medical records, maintain manual log, processed routing records for reconsideration review, processed records to forward to Administrative Law Judge; sort, route an mail daily correspondence. Responsible for generating correspondence to Mississippi hospitals and physcians; perform data entry on records received in the office on a daily basis. Process rural health claims. Responsible for generating individualized letters to physicians and Medicare beneficiaries in Mississippi using Wordperfect 5.1 format.

Sales Auditor 1979-1988

Report retail sales to census bureau, report weekly and month Frederick Atkins, Prepared Lease Department Analysis. Troubleshooter, supervised Department in the absence of supervisor. Audited store CRT, worked on IBM PC (using Lotus 123), operate 10-key, responsible for preparing weekly checks for Lease Department. Prepared weekly reports, released customers billing cycle, prepared monthly closing worksheet, posting to General Ledger report.

Reference: Available upon request

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Clerical Assistant Resume

Jackson, MS

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