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Show Resume TextZachary Stillwater123 Fake Street City, State, Zip CodeCell: 000-000-0000email@email.com SUMMARY Reliable Medical Claims Adjudicator experienced in swift and accurate analyzing of documents to determine eligibility and courses of action. Familiar with fast paced team environments, and capable of maintaining a customer and results oriented focus with attention to detail and accuracy. Motivated, analytically persuasive and comfortable with general accounting principles, claims processing, accounts payable, etc. HIGHLIGHTS
- Exceptional interviewing skills
- Understand paying, negotiating and denying claims
- Solid history with health insurance industry
- Strong unflappable communicator
- On-scene investigation and follow-up
- Proficient with data entry and word processing
- Analytical thinker
- Operate under minimal supervision
- Regular consultation sessions with federal disability adjudicators regarding range of insurance and benefits issues.
- Meet with claimants, law enforcement, witnesses, physicians and other parties to establish best ways to view and process claims.
- Conduct hearings and deliver decisions on disputes of findings.
- Revisit all completed claims to ensure quality assurance and accuracy.
- Adjudicated range of medical benefits claims.
- Met with claimants, law enforcement, witnesses, physicians and other parties to establish best ways to view and process claims.
- Conducted seminars on regulatory procedures and requirements.
- Prepared materials on plan updates, policy changes and regulations.
