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Click here or scroll down to respond to this candidateCandidate's Name 3045 Teton DriveGastonia NC Street Address
PHONE NUMBER AVAILABLEEMAIL AVAILABLEEXPERIENCEKey Benefit Administrators, Fort Mill SCClaims Administrator Tier 31999 - PRESENT Review all pertinent claim information for all detail during processing and requests additional information when needed Determine eligibility and covered benefits for services in accordance with medical, dental and vision plan provisions Identify any system problems with claims processing and work with the proper area to resolve issue Work as a backup for management staff in their absence Maintain statistical and financial accuracy targets for claims processed Meet monthly quality and production expectations Keep abreast of all policy and state mandates for applicable products Enter and process both Self-Funded and Fully Insured medical claims for adjudicationJohn Alden, Charlotte NCBenefit Analyst1997- 1999 Maintained an average of 100 claims processed with a 98% accuracy rate Conducted work status investigations to determine eligibility Supported the Customer Service Department in managing calls to reduce call wait time Resolved difficult claims on behalf of my team leadership EDUCATIONWinston- Salem State University, Winston-Salem NC Bachelor of Arts Degree in Business Administration; Business Information Systems - May 1987SKILLSLeadership skillsMedical Terminology.Detailed knowledge of healthinsurance and third partyadministrationWord and Excel experience |
