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financial counselor resume example with 20+ 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
Highly motivated Sales Associate with extensive customer service and sales experience. Outgoing sales professional with track record of driving increased sales, improving buying experience and elevating company profile with target market.
Skills
  • Staff training
  • Team direction
  • Event coordination
  • Data entry
  • Scheduling and calendar management
  • Customer service
  • Collections experience
  • Accounts payable and receivable
  • Training & Development
Experience
08/2015 to Current
Financial Counselor Hartford Healthcare Wethersfield, CT,
  • Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
  • Used Affinity, Micro MD, Varian and Cerner to input claim, prior authorization and other important medical data into system.
  • Contacted insurance companies to obtain necessary preauthorizations needed for upcoming tests and procedures.
  • Collaborated with internal departments to provide account status updates.
  • Coordinated resolutions for issues and appealed denied authorizations.
  • Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills.
  • Notified ordering providers of denied authorizations.
  • Applied knowledge of Medicare, Medicaid and third-party payer requirements utilizing on-line eligibility systems to verify patient coverage and policy limitations.
  • Performed detailed medical reviews of prior authorization request, following established criteria and protocols.
  • Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers.
  • Clarified patient inquiries and questions to update patient account information in computer system.
  • Explained daily processes and procedures to new hires, promoting better understanding of job tasks.
04/2013 to 08/2015
Insurance Billing Specialist Source Medical Saint Louis, MO,
  • Contacted insurance providers to verify insurance information and obtain billing authorization.
  • Liaised with patients, insurance companies and billing personnel to create and post bills, obtain payments and update system.
  • Reviewed and submitted workers' compensation claims.
  • Established, enforced and optimized billing procedures to streamline operations and minimize aging balances.
  • Investigated and resolved issues to maintain billing accuracy.
  • Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
10/2009 to 04/2013
Insurance Billing Manager Tutera Senior Living Chicago, IL,
  • Conducted insurance verification and pre-authorization, coded radiation therapy, PET scans, and some injections procedures and managed patient charts.
  • Built high-performance team by collaborating with new members on procedural, administrative, collections and compliance areas.
  • Set up and maintained Micro MD electronic billing system.
  • Helped customers to bring accounts into good standing by implementing payment plans.
  • Managed billing calendar and scheduled claims for payments.
  • Resolved billing issues by applying knowledge and completing in-depth research.
  • Led team of 3 staff handling more than $2 to 5 million in monthly charges.
  • Managed all scheduling and payroll for team of 3 staff in busy cancer center for radiation therapy office.
08/1994 to 10/2009
Medical Insurance Billing Specialist U.S. Physical Therapy Lander, WY,
  • Prepared billing statements for patients, ensuring correct diagnostic coding.
  • Determined prior authorizations for medication and outpatient procedures.
  • Reviewed and verified benefits and eligibility with speed and precision.
  • Analyzed and interpreted patient medical and surgical records to determine billable services.
  • Contacted insurance providers to verify insurance information and obtain billing authorization.
  • Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.
  • Completed appeals and filed and submitted claims.
  • Accurately coded diagnostics and prepared billing statements for patients.
  • Applied payments, adjustments and denials into medical manager system.
  • Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
  • Consistently informed patients of financial responsibilities prior to services being rendered.
  • Entered procedure codes, diagnosis codes and patient information into Micro MD, Medical Manager, Varian, Cerner
  • Posted and adjusted payments from insurance companies.
  • Posted charges, payments and adjustments.
Education and Training
Expected in 05/1985 to to
High School Diploma:
South Point High School - South Point, OH
GPA:
Expected in 05/1985 to to
High School Diploma:
Lawrence County Joint Vocational School - Getaway, OH,
GPA:
Expected in 06/2008 to to
Associates of Accounting: Health Care Administration
Ohio University - Ironton OH,
GPA:
Expected in to to
Bachelor of Arts: Health Care Administration
Ohio University - Ironton OH,
GPA:

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Resume Overview

School Attended

  • South Point High School
  • Lawrence County Joint Vocational School
  • Ohio University
  • Ohio University

Job Titles Held:

  • Financial Counselor
  • Insurance Billing Specialist
  • Insurance Billing Manager
  • Medical Insurance Billing Specialist

Degrees

  • High School Diploma
  • High School Diploma
  • Associates of Accounting
  • Bachelor of Arts

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