Claims Specialist

Experienced Customer Service Representative - call center, Claims Processor, Claims Auditor, Benefits Eligibility Specialist. Extremely analytical individual with excellent written and verbal communication skills. Possesses a thorough knowledge of CPT-4, ICD-9 and HCPC coding. Has an extensive knowledge of insurance products including PPO, POS, HMO, HSA, HRA, Managed Care, Indemnity, and Medicare. Known for identifying error trends and taking proactive corrective measures during monthly audits, resulting in increased claims accuracy and overall customer satisfaction. Proved to report accurate quality results for claims, written and verbal inquiries. Approachable yet firm communication technique, motivating cooperation in order to exceed error resolution goals. Results driven individual who combines corporate goals with customer satisfaction for the intended outcome of growth and retention.

Claims Examiner