Medical Claims Analyst Resume

Samantha Gray

North Highlands CA 95660

(916) 987-6543

[email protected]

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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.


Bachelors Degree in Insurance

University of California, Berkeley, CA