HadlockEllisCleanCritDoc(1)
- 1. ELLIS HADLOCK 5645 Fulton Ave ■ Van Nuys, CA 91401 801.472.0579 (h) ■ ellis4music@yahoo.com CLAIMS PROCESSOR Accomplished and results-driven professional with 15+ years of success specializing in claims processing and team leadership in the health insurance industry. Consistently meet or exceed production standards in quantity, accuracy, and timeliness. Confidently work in both team and independent environments. Quick learner, recognized for punctuality, willing to work overtime, and time-management skills. Dedicated employee, committed to top-performance and achieving organizational goals. SUMMARY OF SKILLS 10-Key ▪ Medical Terminology ▪ CPT/ICD-9 Coding ▪ Claims Management ▪ Adjustments Provider Relations ▪ Document Processing ▪ Research & Resolution ▪ Data Entry ▪ Sorting Telephone Etiquette ▪ Quality Assurance ▪ Filing ▪ MS Excel, Word ▪ WinXP, Win7 ▪ FEP Direct System EXPERIENCE REGENCE BLUE CROSS BLUE SHIELD – FEDERAL EMPLOYEE PROGRAM (FEP), SALT LAKE CITY, UT Claims Service Analyst II, 2006 - Present Analyze and timely process high-volume of professional and hospital claims, deferrals, and adjustments. Demonstrate expert knowledge of medical terminology including CPT and ICD-9 codes, Health Care Procedural Coding System (HCPCS), and Rev. Skilled at processing numerous claim types, including outpatient, Medicare, cob, dental, surgery center, home health, and overpayments. Ensured prompt and quality handling of outstanding claims, including extensive follow up. Communicated with providers, members, and other departments, via telephone, correspondence, and email, to obtain missing information on claims. BLUE CROSS OF CALIFORNIA - FEP, WOODLAND HILLS, CA Senior Claims Examiner, 2002 - 2006 Claims Lead, 2000 - 2002 Claims Examiner, Prior - 2000 Achieved progressive leadership advancement by demonstrating superior analytical and claims processing talents. Oversaw <how many? 15 examiners and ensured best practices on quality, production, and timeliness; facilitated training and performance reviews. Processed all claim types and verified all required documentation for acceptability. Reviewed and resolved input errors and eligibility issues. Participated in giving presentations at department meetings. Quickly learned new processes and computer applications to perform daily job requirements. Ensured first-rate customer service and clerical tasks; answered telephone inquiries regarding claims status and eligibility, handled filing and sorting, and processed mail. EDUCATION Microsoft Excel and Windows Certification – CompUSA, Woodland Hills, CA
- 2. Completed General Education studies – Los Angeles Valley College, Van Nuys, CA