LiveCareer-Resume

insurance coordinator resume example with 13+ years of experience

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

Experienced Insurance Coordinator and Credentialing Specialist successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering 13.5 years of experience in Optometry and willingness to take on any challenge.

Skills
  • Medicare and Medicaid knowledge
  • Insurance claims and denial processes
  • Payment planning
  • ICD-10 Coding
  • Problem-solving
  • Insurance Verification
  • Strategic thinking skills
  • Customer service and assistance
  • Accounts Receivable
  • Medical billing and coding
  • Claims
  • Understanding of medical terms
  • Documentation abilities
  • Insurance coverage verification
  • Excellent administrative abilities
  • Great mathematical skills
  • Patient contact
  • Data integrity
  • Account management
  • Organization and Time Management
  • Data Entry Software
  • Appointment Scheduling
  • Critical Thinking
  • Detail-Oriented
  • Administrative Tasks
  • Equipment Troubleshooting and Maintenance
  • Taking Client Histories
  • Customer Service
  • Medical Recordkeeping
  • Problem Solving
  • Time Management
  • Supply Ordering
  • Verbal and Written Communication
  • Medical Charting
  • Invoice Preparation
  • Office Management
  • Claim Forms
  • HIPAA Compliance
  • Office Coordination
  • Insurance Forms
  • Adaptable and Flexible
  • Data Entry
  • CPT Coding
  • Patient Eligibility Requirements
  • Inventory Management
  • Insurance Authorizations
  • Payment Scheduling and Collection
  • Employee Scheduling
  • Flexible Schedule
  • Medical Coding
  • Applicant Qualification
  • New Hire Onboarding
  • Employee Orientation
  • Employee Hiring
  • Employment Recordkeeping
  • Procedure Compliance
  • Policy and Procedure Writing
  • Employee Relations
  • Termination Documentation
  • In-Person and Telephone Interviewing
  • Eligibility Determinations
  • Employee and Applicant Assessment
  • Willingness to Learn
  • Information Protection
  • Training Development and Execution
  • Remote Conferencing and Communication
  • Documentation and Recordkeeping
  • Conflict Resolution
  • Customer Relationship Management
  • Time Tracking and Payroll Administration
Education
Robert B. Glenn Winston Salem, Expected in 05/2005 High School Diploma : - GPA :
Work History
Lehigh Valley Hospital & Health - Insurance Coordinator
Quakertown, PA, 12/2014 - Current
  • Filed and tracked insurance claims and communicated claims status to patients.
  • Prepared insurance claims for submission to clearinghouses or insurance companies.
  • Achieved revenue goals by managing collections and accounts receivables, referral process and insurance billing.
  • Obtained prior authorization and precertification for outpatient procedures.
  • Referenced monthly aging reports to follow up on unpaid claims and obtain maximum reimbursement.
  • Maintained compliance with local, state, and federal regulations governing insurance, Medicare and Medicaid requirements.
  • Obtained data such as patient, insurance ID, insurance provider and medical codes to properly file insurance claims.
  • Verified insurance and communicated coverage to staff and patients.
  • Managed all members of insurance team
Gw Medical Faculty Associates - Credentialing Specialist
Arlington, VA, 12/2014 - Current
  • Received and evaluated applications to look for missing and inaccurate information.
  • Conducted primary source verifications such as background checks and board certifications.
  • Obtained NPI numbers for providers and facilities and updated existing profiles.
  • Enrolled providers and Medicaid, Medicare and private insurance plans.
  • Advocated for staff members, helping to identify and resolve conflicts.
  • Handled applications for all doctors at 6 locations for each insurance company
  • Maintained many doctors CAQH profiles
  • Received and evaluated applications to look for missing and inaccurate information
  • Obtained NPI numbers for providers and facilities and updated existing profiles
  • Enrolled providers and Medicaid, Medicare and private insurance plans
  • Improved office efficiency by effectively managing internal communications and correspondence
Sumitomo Mitsui Banking Corporation - Office Manager
Los Angeles, CA, 06/2008 - 12/2014
  • Established workflow processes, monitored daily productivity and implemented modifications to improve overall performance of personnel.
  • Managed budgets, appointment scheduling, employee and event itineraries and accounts to improve productivity initiatives.
  • Maintained computer and physical filing systems.
  • Established and developed strong administrative team by delivering ongoing coaching and motivation and fostering career advancement.
  • Coached new hires on company processes while managing employees to achieve maximum production.
  • Prepared meeting materials and took clear notes to distribute to staff.
  • Evaluated employee records and productivity to complete employee evaluations.
  • Oversaw office inventory.
  • Monitored and evaluated personnel performance to complete annual reviews, recommend advancement or address productivity concerns.
  • Trained Employees in all areas so everyone was cross trained.

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Resume Overview

School Attended

  • Robert B. Glenn

Job Titles Held:

  • Insurance Coordinator
  • Credentialing Specialist
  • Office Manager

Degrees

  • High School Diploma

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