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behavior technician resume example with 5+ years of experience

Jessica Claire
, , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
Home: (555) 432-1000 - Cell: - resumesample@example.com - : - -
Summary

Effective Medical Claims/Credentialing Processor with 5+ years experience in strong background building rapport with providers to discuss any status or denials. Motivated and Driven performer equipped to handle multiple administrative tasks effectively, Including but not limited to, any and all Medical credentialing, verifications of insurance, medical claims billing, insurance payment posting, and client assistance. Exemplary worker with highly investigative and organized skills when processing everything.

Skills
  • Telephone etiquette
  • Health insurance industry knowledge
  • Medical terms and procedure knowledge
  • Thorough claims reviews
  • Knowledgeable in Microsoft (Excel, Power point, Word, etc)
  • Insurance claims processing
  • Reporting skills
  • Account management
  • Self-motivated professional
  • Good listening skills
  • Adaptability
  • Cultural awareness
  • Supervision
  • Planning and Coordination
  • Patient Assistance
  • Behavioral Health
  • Training & Development
  • Critical thinking
  • Quickbooks 2011-12
  • Behavior management
  • Positive and negative reinforcements
  • Psychiatric population familiarity
  • CPR certified
  • First-aid
  • Data collection
Experience
02/2022 to Current
Behavior Technician Community Action Program For Central Arkansas Ward, AR,
  • Assisted with building life and social skills useful for everyday activities and interactions.
  • Planned and implemented individualized interventions as part of behavior treatment plans.
  • Completed daily client rounds and tracked client movements.
  • Developed and deepened relationships with fellow staff members to enhance team collaboration.
  • Documented patients' activities and behaviors into EHR system for recordkeeping.
  • Understood autism spectrum disorder, associated behaviors and optimum treatments.
08/2018 to 02/2022
Medical Claims Specialist Society Insurance Fond Du Lac, WI,
  • Managed large volume of medical claims on daily basis.
  • Submitted electronic/paper claims documentation for timely filing.
  • Used administrative guidelines as resource or to answer questions when processing medical claims.
  • Responded to correspondence from insurance companies.
  • Communicated verification and authorization status updates to facilitate decision-making for patient admissions and insurance coverage.
  • Communicated effectively with staff, including members of operations, finance and clinical departments.
  • Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
  • Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
  • Determined prior authorizations for medication and outpatient procedures.
  • Generated financial statements and reports detailing accounts receivable status. Posted Ins. payments
  • Assisted clients with setting payment plans and billing questions
  • Stayed current on HIPAA regulations, benefits claims processing, medical terminology, and other procedures.
  • Maintained informational resources, tracking and documenting requests for updates, certification and credentialing.
  • Performed primary source verifications such as criminal histories, licenses and board certifications.
  • Checked applications for missing information and organized all paperwork.
  • Addressed credentialing requests, overseeing compliance with governmental and organizational guidelines regarding tiered data access.
  • Confirmed facility and user credentials to initiate and maintain registration and enrollment processes.
  • Completed enrollments into Medicaid, Medicare and private insurance plans.
  • Processed documents and status-change requests, conducting followup assessment regarding enrollment inquiries.
  • Set up NPI numbers for providers and facilities and updated current profile information.
05/2018 to 08/2018
Insurance Verifications Specialist U.S. Physical Therapy Brunswick, GA,
  • Reviewed patient cases per week and verified insurance coverage information.
  • Observed strict procedures to protect sensitive patient information, including medical records and payment data.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Made contact with insurance carriers to discuss policies and individual patient benefits.
  • Verified client information by analyzing existing evidence on file.
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.
09/2016 to 03/2018
Medical Claims Representative Christus Trinity Mother Frances Hospital City, STATE,
  • Managed large volume of medical claims on daily basis.
  • Used administrative guidelines as resource or to answer questions when processing medical claims.
  • Reported policy changes and company conditions affecting customer satisfaction.
  • Responded to correspondence from insurance companies.
  • Collected customer feedback and made process changes to exceed customer satisfaction goals.
  • Gathered forms, copied insurance cards and verified patient information for billing and insurance filing.
  • Located errors and promptly refiled rejected claims.
  • Trained new employees on multiple medical billing programs and data entry software.
Education and Training
Expected in 05/2024 to to
Associate of Science: Medical Office Management
Tyler Junior College - Troup, TX
GPA:

Courses Taken:

  • Medical Terminology
  • Professional Writing
  • Psychology
  • Business Computer Tech (Excel, Word, Power point, etc.)
  • Musical Arts

Next Course:

  • A&P
Expected in 03/2017 to to
GED:
TJC West Campus - Tyler, TX,
GPA:
Certifications
  • Completed CNA Training - Mar 2017
  • Completed Mental Health First Aid Training- Aug 2019
  • Completed CCBHC Training- May 2020
  • Completed PMAB Training- Oct 2020
Languages
English:
Professional
Negotiated:

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Resume Overview

School Attended

  • Tyler Junior College
  • TJC West Campus

Job Titles Held:

  • Behavior Technician
  • Medical Claims Specialist
  • Insurance Verifications Specialist
  • Medical Claims Representative

Degrees

  • Associate of Science
  • GED

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