Medical Claims Adjudicator Resume

When writing a Medical Claims Adjudicator Resume remember to include your relevant work history and skills according to the job you are applying for. Whether you're seeking an entry-level position or have been in your career for a few years, exposing your relevant achievements in your resume can allow you to stand out and get that job interview.

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Here is the Medical Claims Adjudicator Resume example:

Leann Hodge

1219 Stadium Drive

Franklin, MA 2038

(555)-555-5555

[email]

Job Objective Seeking a Medical Claims Adjudicator position that offers an immediate challenge, career opportunity and advancement.

Highlights of Qualifications:

Highly experienced in handling, processing, and settling medical insurance claims
Sound knowledge of medical terminology, coding, and billing standards
Immense knowledge of various health insurance, HMO, and managed care principles
Familiarity with MS Office, Outlook calendar, and Internet Explorer
Ability to comply with HIPAA and other applicable regulatory guidelines
Ability to review and submit medical claims, in a timely manner

Professional Experience:

Medical Claims Adjudicator

Mercer, Franklin, MA

August 2012 – Present

Responsibilities:

Assessed, approved, and denied various medical claim requests received.
Computed all medical benefits due and assisted with payment initiations.
Prepared and dispatched claim related correspondence to claimants and third party agencies.
Interpreted and followed government regulations and company policies, as applicable.
Informed and explained clients about medical terms and concepts, clearly.
Operated computer and used Microsoft Office programs, efficiently.

Medical Claims Adjudicator

CareCentrix, Franklin, MA

May 2009 – July 2012

Responsibilities:

Researched, processed, and resolved various medical claims for clients.
Reviewed and maintained all medical records and claim appeal materials.
Wrote and submitted all work related reports, accurately and on time.
Interpreted and followed government-approved insurance regulations and Social Security Act.
Answered phone calls from clients and responded to email and letters, in a professional manner.
Developed and maintained positive relationship with claimants and insurance providers.

Education

Bachelor’s Degree in Health Insurance

Porterville College, Porterville, CA