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medical claims processor

  • Enter referrals and prior approvals into authorization system
  • Process medical claims
  • Mastered interpersonal and oral/written communication skills
  • interpret contracts accurately, and make sound judgments based on the interpretations
  • High attention to detail and confidentiality
  • Resolved claim questions for clients
  • Administrative duties as assigned. 

medical claims processor/mental health customer service operator

  • Responsbile for taking a high volume of calls from members as well as mental health providers. 
  • Sending back incorrectly processed claims to be reprocessed.  Documenting each call. 
  • Giving general information about claim’s processing.  Sending tracers, eligibility status and benefit quotes.
  • As a Data entry clerk I processed about 200 to 250 medical claim’s per day.  I researched member and provider information.
  • Handeling confident medical claims.  I also received numerous “perfect attendance” awards.