Medical Claims Analyst Resume

Bradley Moore

7930 Carpenter St, Apt#45

Seattle, WA 98119

(555)-555-5555

[email]

Job Objective To secure a Medical Claims Analyst position in a well established organization with a stable environment.

Highlights of Qualifications:

• Sound knowledge of CPT, ICD-9, and HCPCS coding guidelines and medical terminology
• In-depth knowledge of healthcare and claims concepts
• Extensive knowledge of electronic billing systems
• Comprehensive knowledge of pharmaceutical claims
• Excellent written and oral communication skills
• Excellent analytical, critical thinking and problem solving skills

Professional Experience:

Medical Claims Analyst

Crawford & Company, Seattle, WA

August 2005 – Present

• Retained high level of security within Government guidelines in the claim submission and review process.
• Performed and conducted the pre adjudication of claims as required by the client.
• Developed and prepared receivable targets for clients.
• Performed and conducted Claim Analysis for the benefit of the practice and clients.
• Created reports for clients to include in data exchange meetings.

Medical Claims Analyst

WellPoint, Inc, Seattle, WA

May 2000 – July 2005

• Performed data entry of claims into an electronic claiming system.
• Authorized claims and ensured all information is processed accurately and in a timely manner.
• Entered, recorded and tracked data entry claim receipts using an excel spreadsheet.
• Accessed and utilized department mail, count mail, stamp and date.
• Scanned claims after payment processed.
• Interacted with management on workload, issues and backlog.

Education

Bachelors Degree in Insurance

University of California, Berkeley, CA