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Insurance Coordinator Resume Example

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Jessica Claire
Montgomery Street, San Francisco, CA 94105
Home: (555) 432-1000 - Cell: - resumesample@example.com - -
Summary
Meticulous coordinator, excellent at juggling multiple tasks and working under pressure. Outstanding relationship building skills. Action-oriented with strong ability to communicate effectively with executive and business audiences. Excellent client and project management skills.
Skills
AllScripts Practice Management, Google Chrome, Microsoft Outlook/Word/Excel/Exchange, Mozilla Firefox, Relay Clearance, Sunrise Clinical Manager, Xtuple, Citrix Software, Problem Solving, Interpersonal Skills, Oral and Written Communication
Experience
11/2015 to Present
Insurance Coordinator Community Health System Seminole, OK,
  • Meets regularly with ESRD dialysis patients (792 patients / 6 clinics) to educate on insurance options (e.g.,.
  • EGHP, Medicare, Medicaid, Medicare Supplement, State Renal programs and COBRA).
  • Identifies, addresses, researches and resolves insurance coverage issues.
  • Explores, recommends, and coordinates varied financial assistance options available to FKC dialysis patients to ensure the provision of the best financial resources possible for each patient, while maximizing revenue for the company.
  • Audits all patient insurance information to ensure accuracy for the Accounts Receivable Department.
  • Addresses any identified anomalies or discrepancies, researches and responds to inquiries as needed.
  • Analyzes patient insurance reports to ensure appropriate and accurate information is sent to billing group.
  • Provides direction to billing group for correction of any discrepancies identified.
  • Provides IC Manager, IC supervisor and QA team members with bi-weekly and monthly reports of patient' primary and secondary insurance status along with documentation regarding current plans of action as required.
  • Supports Director of Operations and Regional Vice President with departmental functions.
  • Skills: Patient Trak, Relay Clearance, Soarian Financials (eCube), Office365, Sharepoint, GMS Grant Systems, Internet Explorer Mozilla Firefox, Other Proprietary Applications, Excel, Problem Solving, Oral and Written Communication, Telecommuting.
06/2015 to 11/2015
Loss Mitigation Specialist II S&T Bank New Bethlehem, PA,
  • Collected insurance claim accounts, or deceased accounts that required deviation from routine processes and procedures.
  • Monitored over 200 accounts weekly while continuing collection efforts.
  • Collected over 3 Million in claims/deceased accounts from 6/2015 to 11/2015.
  • Clear and persuasive oral communication to assist customers with account resolution options.
  • Maintained data integrity, ensure completeness and accuracy of account information.
  • Skills: Daybreak Management Solutions, FDI/DealerTrack Title Manager, Doc Connect, Microsoft Word, Microsoft Excel, Microsoft Outlook, Problem Solving, Quality Control.
04/2014 to 04/2015
Patient Authorization Representative Ucla Health Yuma, AZ,
  • Regularly obtained pre-authorizations for 60 + patients daily from insurance companies for services to be rendered at outpatient chemotherapy facilities for further patient treatment and project management planning.
  • Provided daily pre-certification billing activities and correspondence between Talyst customers and insurance companies via phone, email, letter.
  • Tracked claim status.
  • Maintained discretion and confidentiality for HIPAA compliance in reviewing the patient demographic and medical information to determine critical points for medical project management.
  • Increased revenue for department by 20%.
  • Contacted applicable insurance companies, and relayed pertinent patient information to them for billing and medical pre-authorization purposes.
  • Assisted with recruitment and interview process.
  • Created interview questionnaire,.
  • Interviewed potential new hires.
  • Mentored and trained new employees.
11/2012 to 02/2014
Enterprise Credentialing Auditor III Sunrise Senior Living Sonoma, CA,
  • Implemented procedures and activities related to the credentialing, re-credentialing, and privileging of providers.
  • Obtained documents, clearances, certificates and approvals from local, state and federal agencies.
  • Prepared files for credentialing committee review.
  • Maintained provider profiling system and communicated with providers by phone and email regarding credentialing status and information.
  • Conducted audits and supported department projects.
  • Served as liaison between the staff and all departments to coordinate and provide overall continuity of staff activities.
  • Provided guidance and expertise to less experienced staff.
  • Maintained confidentiality of provider records in compliance with HIPAA guidelines.
  • Processed and completed files on par with Production Standards.
  • Knowledge of NCQA and URAC standards.
  • Skills: Internet Explorer, Lotus Notes, Microsoft Office Suite, Microsoft Outlook, Mozilla Firefox, Premier Production Inquiry, Vistar, Quality Control.
10/2011 to 01/2012
Personal Caregiver Mac Property Management Chicago, IL,
  • Assisted with personal /hospice care and daily activities for variety of clients, including but not limited to those with Alzheimer's, Parkinson's, and Dementia.
  • Assisted with walking and light exercise.
  • Meal preparation, transportation and companionship.
  • Light housekeeping, errands, medication reminders.
  • Recorded daily care notes, reported any significant changes to agency office.
  • Practiced basic and environmental safety precautions, basic hygiene and infection control, emergency procedures.
  • Confidentiality of client personal, financial, health information (HIPAA).
  • Understanding of abuse and neglect.
03/2010 to 01/2012
Leasing Manager M&L Properties City, STATE,
  • Managed and filed records of all community transactions and submitted on timely basis (e.g., rent rolls, delinquency reports, move-in/move-outs, etc.).
  • Performed other clerical functions.
  • Maintained 96% occupancy after second month of employment.
  • Provided oral and written vendor/contractor communications concerning scheduling, billing, vendor relations and certificates of insurance.
  • Responsible for creative design of flyers and other marketing materials.
  • Ensured that A/P invoices were submitted to corporate office for payment, handled petty cash and all funds.
  • Managed 6 service technicians, 3 make-ready technicians, 2 groundskeepers, 3 painters, and 7 housekeepers in two locations.
  • Streamlined procedures and systems to ensure orderly, efficient workflow.
  • Interviewed potential residents.
  • Resolved resident concerns and requests on timely basis to ensure resident satisfaction with management.
  • Created and implemented resident retention programs (e.g., resident functions, special promotions, monthly newsletters, etc.).
  • Managed proper response and handling of all community emergencies with staff, residents, buildings, etc.
  • within company guidelines to minimize liabilities (e.g., criminal activity at community, employee/resident injuries, fires, floods, freezes, etc.).
  • Skills: Microsoft Office Suite, Mozilla Firefox, Internet Explorer, Planning/Organizing, Problem Solving, Quality Control, Adaptability, Promote Safety and Security.
Education and Training
Expected in September 2014
BS: Business Management
University of Phoenix - Dallas, TX
GPA:
Business Management
Activities and Honors
Skills
Accounts Receivable, Premier, A/P, agency, basic, billing, bi, chemotherapy, Citrix, clerical, oral communication, Interpersonal Skills, Oral, creative design, client, clients, dialysis, direction, documentation, email, ESRD, Financials, financial, funds, hospice care, infection control, insurance, Internet Explorer, notes, Lotus Notes, Director, marketing materials, Meal preparation, Microsoft Excel, Excel, Exchange, Microsoft Office Suite, Office, Microsoft Outlook, Sharepoint, Word, Microsoft Word, newsletters, Organizing, patient treatment, persuasive, Problem Solving, processes, project management, QA, Quality Control, recruitment, Safety, scheduling, supervisor, phone, transportation, vendor relations, workflow, written, Written Communication

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Resume Strength

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  • Strong Summary
  • Target Job

Resume Overview

School Attended
  • University of Phoenix
Job Titles Held:
  • Insurance Coordinator
  • Loss Mitigation Specialist II
  • Patient Authorization Representative
  • Enterprise Credentialing Auditor III
  • Personal Caregiver
  • Leasing Manager
Degrees
  • BS

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