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Medical Claims Secretary Resume Sample

This is a sample resume for the post of Medical Claims Secretary. A Secretary’s job, be it from any department, requires full-time commitment and low level of risks or mistakes. A Claim Secretary is a person who handles all the accidental and casual cases of the clients. The Medical Claim requires case solutions on urgent basis. The insurance company is more interested in hiring a resourceful person with references and contacts for his claims with additional knowledge of medical field and great judgment skill. A person who has the quality, experience and capability of solving all cases to customer’s satisfaction Resume is your first interface with the employer. The resume sample given below should guide in building an impressive resume. Finally adding references to your resume will stand your resume out among others.

NAME:XYZ

United Arab Emirates
Mobile No.: 0000

E-Mail Address: xxxx

CAREER OBJECTIVE:

To work with your company for any position I can utilize my medical profession, skills and work experience.

PROFESSIONAL QUALIFICATIONS:

  • Provides quality service  to  clients  and  effectively  assess  and  process  claims  and approval according to set standards.
  • Communication and leadership skills; excellent customer service relation.
  • Knowledge in MS Office software – Word, Excel, PowerPoint.
  • Recognized record of reliability and responsibility.
  • Resourceful problem solver capable of implementing solutions to complex problems; Flexible, can work under pressure and overtime as needed.
  • Remain calm and professional throughout critical incidents, with enthusiasm.
  • Ability to create a positive working environment.
  • Commitment to excellence and high standards.
  • Strong analytically skills, capable of assessing conditions and implementing appropriate intervention.

PROFESSIONAL EXPERIENCE:

Medical Claims Secretary

Arab Gulf Health Services- Nextcare

Sheikh Zayed Road, Dubai, UAE

September 22, 2014 – Present

  • Responsible on all claims update on the system and effectively adhere documentation /filing to the set standards.
  • Facilitate urgent follow-ups from call-center and channel it to respective departments.
  • Organize files, claims documents received and medical reports according to set standards and retrieved files as necessary.
  • Take charge of the high-cost claims sheet.
  • Accurately enter data on the system both Inpatient and Outpatient claims.
  • Determine all incoming faxes and channel documents to respective department accordingly.
  • Record all incoming and outgoing claims in the system and thru excel sheet.
  • Entertain all inquiries from phone calls, faxes and email communication.
  • Follow-up all status of claims, until a final judgment is made by medical claims officer.
  • Offers assistance to other team members.

Medical Claims Assessor

Arab Gulf Health Services.

Sheikh Zayed Road, Dubai, UAE

  • Ensuring patients membership validity and insurance coverage.
  • Enter ICD codes for patient’s complaints and diagnosis.
  • Enter CPT codes for patient request of procedures and other requested items.
  • Provide Written approval  through  emails,  faxes,  and  computer  generated system .
  • Applying intended coinsurance and deductible as per insurance policy.
  • Application of  adjudication  procedures  to  make  sure  proper  payment  of claims.
  • Review pending and denied claims submitted by providers for re-evaluation
  • Provide actual decisions for approval and denial in due time.
  • Providing quality customer service to members, providers, and other insurance companies.

General Ward Nurse 

Saint Jude Clinic and Hospital

Sto. Niño, South Cotabato, Philippines

Nurse Volunteer

Saint Jude Clinic and Hospital

Sto.Niño, South Cotabato, Philippines

CERTIFICATE / LICENSE:

  • Professional Board Examination for Nurses,
    License No.: 0000
    • Registered IV Therapy Nurse
    Current Member
    License No.: 0000
    • Philippine Nurses Association
    Current Member

ADVANCED TRAINING’S AND SEMINARS:

April 18, 2009                                      Cardio-pulmonary Assessment and Emergency Management

October 21, 2008                                 Seminar on Hospital Waste Management Program

October 16, 2008                                 Nursing Alert! Look, Listen, and Feel: Sharpening Your Assessment Skills

August 2. 2008                                     Seminar on Safe Nursing Practice

July 5, 2008                                          IV Chemotherapy

June 14, 2008                                       Seminar on Nursing Management for Myocardial Infarction

May 27, 2008                                      Dosage and Solutions Competency Review

May 22-24, 2008                                                Basic IV Therapy Training for Nurses

May 15, 2008                                      Seminar on Care of Patients on

May 13, 2008                                      Seminar on Training During Emergencies

April 26, 2008                                      Seminar on Total Parental Nutrition

April 19, 2008                                      Selected Cardiovascular Drugs: a Refresher

EDUCATIONAL BACKGROUND:

DAVAO DOCTORS COLLEGE

General Malvar St. Davao City

  • Bachelor of Science in Nursing, 2007

NOTRE DAME OF NORALA

PoblacionNorala, South Cotabato

  • High School Graduate, 2003

NOTRE DAME OF NORALA

PoblacionNorala, South Cotabato

  • Elementary School Graduate, 1999

PERSONAL DATA

Age                                            : 30 years old

Date of Birth                           : January 16, 1988

Sex                                            : Female

Civil Status                              : Single

Citizenship                               : Filipino

Religion                                    : Roman Catholic

Language Spoken                   : English; Tagalog

References :

available upon request.