Livecareer-Resume
Jessica Claire
Montgomery Street, San Francisco, CA 94105
Home: (555) 432-1000 - Cell: - resumesample@example.com - -
Professional Summary
  • Years of successful experience in [Skill] and [Skill]. Recognized consistently for performance excellence and contributions to success in [Industry] industry. Strengths in [Skill] and [Skill] backed by training in [Area of study]. Highly trained professional with a background in verifying insurance benefits and creating appropriate patient documentation. An established Insurance Verification Specialist known for handling various office tasks with undeniable ease.
Skills
  • Recordkeeping
  • Accounting familiarity
  • Administrative support
  • Internal communications
  • AP/AR understanding
  • Compensation and benefits
  • Workers' compensation
  • Documentation and control
  • OSHA compliance
  • Employee training and development
  • Employee timesheet processing
  • Invoice Processing
  • Meeting arrangements
  • AP/AR proficiency
  • Business correspondence
  • CMS-1500 billing forms
  • Letter preparation
  • Account Reconciliation
Work History
07/2009 to Current
Group Plan Administrator Community Health System Orange Beach, AL,
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
  • Observed strict procedures to protect sensitive patient information, including medical records and payment data.
  • Verified client information by analyzing existing evidence on file.
  • Determined appropriateness of payers to protect organization and minimize risk.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Posted payments to accounts and maintained records.
  • Reviewed [Number] patient cases per week and verified insurance coverage information.
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.
  • Made contact with insurance carriers to discuss policies and individual patient benefits.
  • Devoted special emphasis to punctuality and worked to maintain outstanding attendance record, consistently arriving to work ready to start immediately.
  • Saved $[Amount] by implementing cost-saving initiatives that addressed long-standing problems.
  • Maintained excellent attendance record, consistently arriving to work on time.
  • Resolved conflicts and negotiated mutually beneficial agreements between parties.
  • Monitored social media and online sources for industry trends.
  • Resolved [Type] problems, improved operations and provided exceptional client support.
  • Handled [Number] calls per [Timeframe] to address customer inquiries and concerns.
  • Led [Type] team in delivery of [Type] project, resulting in [Result].
  • Drove operational improvements which resulted in savings and improved profit margins.
  • Transported [Product or Service] to customer locations [Timeframe].
  • Increased customer satisfaction by resolving [Product or Service] issues.
  • Developed team communications and information for [Type] meetings.
  • Managed quality assurance program, including on-site evaluations, internal audits and customer surveys.
  • Accurately inputted all patient and insurance information into company's computer system using [Software].
  • Worked with [Type] customers to understand needs and provide [Type] service.
07/2009 to Current
Insurance Coordinator State Of North Carolina Warrenton, NC,
  • Filed and tracked insurance claims and communicated claims status to patients.
  • Prepared insurance claims for submission to clearinghouses or insurance companies.
  • Maintained compliance with local, state, and federal regulations governing insurance, including Medicare and Medicaid requirements.
  • Obtained prior authorization and precertification for outpatient procedures.
  • Obtained data such as patient, insurance ID, insurance provider and medical codes to properly file insurance claims.
  • Reviewed accounts receivable reports, insurance contracts and weekly and monthly financial reports.
  • Verified insurance and communicated coverage to staff and patients.
  • Referenced monthly aging reports to follow up on unpaid claims and obtain maximum reimbursement.
  • Modified, updated and processed existing policies.
  • Processed invoices and processed Inter-office billing.
  • Processed and recorded new policies and claims.
  • Received and routed business correspondence to correct departments and staff members.
  • Carried out administrative tasks by communicating with clients, distributing mail and scanning documents.
  • Calculated adjustments, premiums, and refunds.
  • Answered telephone calls to field inquiries from clients, vendors and various other callers seeking information.
07/2009 to Current
Workers' Compensation Administrator Lineage Logistics Plano, TX,
  • Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
  • Evaluated original investigation reports and documents to resolve secondary concerns.
  • Collected and tracked evidence in support of legal processes.
  • Conducted thorough property investigations to identify and classify damages for customer claims.
  • Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
  • Interviewed agents and claimants to correct errors or omissions and investigate questionable claims.
  • Investigated and assessed damage to property and reviewed property damage estimates.
  • Examined claims forms and other records to determine insurance coverage.
  • Reviewed police reports, medical treatment records and physical property damage to determine extent of liability.
  • Worked with [Type] customers to understand needs and provide [Type] service.
  • Saved $[Amount] by implementing cost-saving initiatives that addressed long-standing problems.
  • Developed team communications and information for [Type] meetings.
  • Devoted special emphasis to punctuality and worked to maintain outstanding attendance record, consistently arriving to work ready to start immediately.
  • Led [Type] team in delivery of [Type] project, resulting in [Result].
  • Handled [Number] calls per [Timeframe] to address customer inquiries and concerns.
  • Resolved conflicts and negotiated mutually beneficial agreements between parties.
07/2009 to Current
Safety Coordinator OG Packing Co. City, STATE,
  • Mentored and supported staff in identifying and implementing procedures and practices to protect safety and security of workers.
  • Leveraged statistical analysis to improve awareness, change behavior and drive continuous improvement in programs and processes.
  • Conducted incident investigations, participated in audits and collected data and information to maximize workplace safety.
  • Created safe work environment by complying with safety, health and security requirements.
  • Supported interaction with local emergency response agencies and responders to coordinate work site security requirements.
  • Accompanied, documented and reported OSHA inspections, insurance oversight and other formal safety and security measures at work site.
  • Assessed compliance of site operations, accuracy of forms and adequate employee notification for different policies.
  • Updated contract, project and crew leaders with daily status reports on observations and incidents.
  • Conducted safety evaluations to recommend alternate safety procedures.
  • Conducted new employee interviews, orientation and training, and provided ongoing monitoring and evaluation.
  • Inspected job sites and completed in-depth reports outlining safety concerns and corrective recommendations.
  • Monitored safety and assessed risk levels and mitigation strategies at industrial worksites and on construction jobs.
  • Developed, implemented and trained on safety programs and injury prevention programs for [Number] clients in [Type] industry.
  • Collaborated with contract management and optimized procedures at numerous sites with [Number]+ employees.
  • Used [Software] to create and maintain records of all safety rules, regulations and guidelines.
  • Directed recordkeeping and paperwork preparation in line with OSHA requirements.
  • Handled [Number] calls per [Timeframe] to address customer inquiries and concerns.
  • Resolved [Type] problems, improved operations and provided exceptional client support.
  • Resolved conflicts and negotiated mutually beneficial agreements between parties.
  • Managed quality assurance program, including on-site evaluations, internal audits and customer surveys.
Education
Expected in 04/1988
Associate of Arts: Business Administration
Mayland Community College - Spruce Pine, NC
GPA:
Certifications
  • First Aid/CPR Certified

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Resume Overview

School Attended

  • Mayland Community College

Job Titles Held:

  • Group Plan Administrator
  • Insurance Coordinator
  • Workers' Compensation Administrator
  • Safety Coordinator

Degrees

  • Associate of Arts

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