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JC
Jessica Claire
, , 100 Montgomery St. 10th Floor (555) 432-1000, resumesample@example.com
Summary

Focused Medical Insurance Coordinator with 13 years' background in coordinating and processing insurance payments, facilitating billing and managing patient accounts. Proficient in liaising with patients, staff, and insurance providers to maintain accounts and achieve optimal reimbursement. Successful in obtaining authorizations for all medical inpatient and outpatient services. Knowledgeable in keeping sensitive patient data confidential while maintaining knowledge of Medicaid and private policy benefits. Possessing great relationship building and communication skills. Looking to tackle new challenges with a company that values dynamic skills and a strong work ethic. Strong attention to detail and exceptional coordination skills. Self-motivated and poised professional who has background in contacting insurance companies for critical information and crafting patient documents for billing purposes.

Skills
  • Employee management
  • Insurance terminology
  • Patient rapport
  • Secure data practices
  • Medical terminology
  • Database management
  • Insurance plan verification
  • Medicaid knowledge
  • Active listening
  • Planning
  • Time management
  • Problem resolution
  • Troubleshooting
  • Organizational skills
  • Communication
  • Multitasking
  • CMS guidelines
  • CPT coding
  • Account management
  • Revenue cycle management
  • Insurance claims processing
  • Accounting skills
  • Medical terminology proficiency
  • Documentation skills
  • Outstanding clerical abilities
  • Background in insurance
  • Ability to prepare reports
  • Regulatory compliance understanding
  • Exceptional recordkeeping abilities
  • Telephone etiquette
  • Friendly, positive attitude
  • Computer skills
  • Microsoft Office
  • Critical thinking
  • Customer service
  • Reliable and trustworthy
Experience
09/2013 to 03/2015 Billing Specialist Altru Health System Clinic | Thief River Falls, MN,
  • Contacted insurance providers to verify insurance information and obtain billing authorization.
  • Answered customer invoice questions and resolved issues discovered during invoicing and collection process.
  • Processed and sent invoices, adjustments and credit memos to customers.
  • Performed data import, scanning or manual keying processes to verify invoice accuracy.
  • Investigated and resolved issues to maintain billing accuracy.
  • Established, enforced and optimized billing procedures to streamline operations and minimize aging balances.
  • Submitted claims to insurance companies and researched and resolved denials and explanations of benefit rejections.
  • Calculated discounts, percentage allocations and credits.
  • Liaised with patients, insurance companies and billing personnel to create and post bills, obtain payments and update system.
  • Scheduled patients and updated insurance, payment history and personal information.
  • Reviewed and submitted workers' compensation claims.
  • Added current information to accounts, including demographic, personal and payment details.
  • Input data into digital system for recordkeeping.
  • Reviewed and interpreted insurance explanation of benefits statements and applied to patient accounts.
  • Accurately and concisely documented notes in patient files in adherence with HIPAA regulations.
  • Contacted customers to obtain and submit payments.
  • Assessed and resolved variances in accounts, databases and bills.
08/2010 to 09/2013 Financial Counselor/Coordinator/Front Office Supervisor Palmetto Health | Travelers Rest, SC,
  • Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
  • Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
  • Updated all patient and insurance data regularly and carefully inputted changes into company's computer system.
  • Checked documentation for appropriate coding, catching errors and making revisions.
  • Examined claims, records and procedures to grant approval of coverage.
  • Retained strong medical terminology understanding in effort to better comprehend procedures.
  • Handled billing related activities focused on medical specialties.
  • Signed payment approvals accepted claims.
  • Performed verification of Medicare coverage.
  • Identified important patient and demographic information.
  • Created and maintained accurate and confidential patient files according to regulatory mandates.
  • Pulled patient files and forwarded to appropriate offices for processing.
  • Maintained office supplies inventory by checking stock and ordering new supplies as needed.
  • Assisted 300-400 patients weekly by reviewing personal cases and insurance coverage information.
  • Kept office spaces well-stocked with administrative and medical supplies.
  • Helped patients complete paperwork and explained processes and procedures.
  • Updated patient financial information to promote accurate record keeping.
  • Contacted other medical facilities to confirm medical histories and prevent inaccurate diagnoses.
  • Communicated with patients to gather intake data and verify chart information.
  • Adhered to all HIPAA requirements to safeguard patient confidentiality.
  • Recruited and hired qualified candidates to fill open positions.
  • Collaborated with staff to maximize customer satisfaction, streamline procedures and improve bottom-line profitability.
  • Maintained ongoing system for development, recruitment, recognition and retention of store crew and management.
  • Managed shifts in absence of store manager to deliver excellent customer service while promoting sales.
  • Oversaw day-to-day office operations, including receiving and organizing correspondence, answering and forwarding calls and creating business letters and records.
  • Maintained impeccable office organization to support efficiency, professionalism and performance objectives.
  • Managed office inventory and placed new supply orders.
  • Handled scheduling and managed timely and effective allocation of resources and calendars.
  • Coordinated office activities and operations to secure efficiency and compliance with company policies.
  • Directed and oversaw office personnel activities.
  • Conducted staff performance evaluations to monitor progress and recommend professional development plan.
  • Kept close eye on front desk to promptly address and resolve issues.
  • Created schedule of front office workers.
  • Hired and trained front desk agents and monitored compliance with company procedures.
  • Assisted with interviewing job applicants by asking appropriate questions and offering insight and feedback.
03/2002 to 10/2010 Financial Insurance Coordinator Prisma Health Upstate | City, STATE,
  • Validated insurance and advised patients of benefits and coverage.
  • Obtained maximum reimbursement by following up on unpaid claims and reviewing monthly aging reports.
  • Efficiently managed collections and receivables, referrals process and billing to meet revenue goals.
  • Engaged customers and provided high level of service by carefully explaining details about documents.
  • Checked documentation for appropriate coding, catching errors and making revisions.
  • Instructed clients on amounts covered under benefits plans in easy-to-understand terminology.
  • Examined claims, records and procedures to grant approval of coverage.
  • Handled billing related activities focused on medical specialties.
  • Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
  • Signed payment approvals accepted claims.
  • Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
  • Updated all patient and insurance data regularly and carefully inputted changes into company's computer system.
  • Followed specific security rules and guidelines to protect sensitive data, including patient medical records and payment card information.
  • Retained strong medical terminology understanding in effort to better comprehend procedures.
  • Performed verification of Medicare coverage.
  • Identified important patient and demographic information.
  • Assisted 300 patients weekly by reviewing personal cases and insurance coverage information.
  • Pulled patient files and forwarded to appropriate offices for processing.
  • Created and maintained accurate and confidential patient files according to regulatory mandates.
  • Updated patient financial information to promote accurate record keeping.
  • Communicated with patients to gather intake data and verify chart information.
  • Contacted other medical facilities to confirm medical histories and prevent inaccurate diagnoses.
09/2001 to 03/2002 Patient Scheduler Cancer Centers Of The Carolinas | City, STATE,
  • Scheduled new and existing patients as walk-ins or by phone.
  • Checked with doctors for availability.
  • Answered office phones and emails.
  • Checked patient insurance and collected pre-authorizations from providers.
  • Assisted patients in filling out pre-appointment paperwork.
  • Worked with operating facilities to schedule procedures on behalf of 120/day 10 physicians.
  • Gathered current medical information and reviewed histories to gather details for physicians.
  • Distributed treatment and procedural information to patients.
  • Double checked medical record databases.
  • Verified appointment times with patients, preparing charts, pre-admission and consent forms.
  • Assisted physicians by preparing patients for procedures, including EKGs, phlebotomy, glucose testing and pulmonary function tests.
  • Kept facility stocked with necessary supplies, equipment and instruments.
  • Prepared patients for examinations, taking vital signs and updating medical histories.
  • Communicated with patients by phone and via written correspondence.
  • Transmitted physician's orders to patients, counseling on execution and addressing follow-up questions.
Education and Training
Expected in 06/1999 High School Diploma | Pickens High School, Pickens, SC GPA:

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Resume Overview

School Attended

  • Pickens High School

Job Titles Held:

  • Billing Specialist
  • Financial Counselor/Coordinator/Front Office Supervisor
  • Financial Insurance Coordinator
  • Patient Scheduler

Degrees

  • High School Diploma

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