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insurance coordinator resume example with 17+ 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

Skilled healthcare billing professional with 35 Years of experience in coordinating, processing and troubleshooting insurance payments. Adept at managing collections and receivables, referral process and insurance billing functions. Successful in recommending strategies to improve revenue cycle management and workflow.

Skills
  • Strong problem solving, critical thinking and research skills
  • Excellent written and oral communication skills
  • Strong customer skills with both internal and external customers.
  • In-depth knowledge following up on claim status, resolving insurance denials, rejections, claims resubmission and filing appeals.
  • Extensive knowledge in medical claims billing, verifying eligibility and benefits, charge entry and calculating contractual reimbursement.
  • Management experience with diverse staff including, nurses, medical assistants, receptionist's, charge entry staff and patient financial service representatives.
  • Extensive experience in team and staff management including development of departmental job descriptions and procedures. Hiring, training and scheduling. Staff performance appraisals, coaching, goal setting and regular staff meetings.
  • In-depth knowledge of insurance contracts, medical terminology, coding and reimbursement.
Experience
Insurance Coordinator, 01/2017 to Current
South Shore HealthKingston, MA,
  • Verified patients had proper insurance coverage prior to procedures or appointment scheduling.
  • Filed insurance claims by obtaining and entering data related to patient, insurance provider and medical code for procedures and services provided.
  • Obtained maximum reimbursement by following up on unpaid claims and reviewing monthly aging reports.
  • Secured pre-authorizations for orthodontic procedures performed in office.
  • Submitted claims to insurance companies and clearinghouses.
  • Collected payments, processed receipts and informed policyholders of outstanding balances.
  • Updated patient and insurance data and input changes into the practice computer system.
  • Ensure patients have a completed the appropriate financial consent forms and financial agreements per their treatment plan.
  • Perform End of Day processing as needed.
  • Answer phone calls and make patient appointments.
Billing Coordinator, 08/2011 to 06/2015
CarecloudEnglewood, OH,
  • Contacted insurance providers to verify insurance information and obtain billing authorization.
  • Submitted appeals on behalf of patients for denied claims.
  • Kept up-to-date with details of insurance plans and company requirements.
  • Reported past due payments to collections department.
  • Managed daily operations for billing department handling $ per month in payments.
  • Investigated and resolved issues to maintain billing accuracy.
  • Input payment history and other financial data to keep customer accounts up-to-date in system.
  • Resolved reimbursement discrepancies by analyzing information and notifying manager.
  • Reviewed and sent accounts with overdue balances to third-party collections for settlement.
  • Submitted claims to insurance companies and researched and resolved denials and explanations of benefit rejections.
  • Established, enforced and optimized billing procedures to streamline operations and minimize aging balances.
Accounts Receivable Analyst, 04/2009 to 06/2010
Altra Holdings, Inc.Niagara Falls, NY,
  • Utilized performance improvement matrix to identify defects and recommend improvements to current operational workflows.
  • Decreased unbilled transports from 28 days to 6 days within 6 months by implementing new policies and procedures for verification and coding.
  • Reduced bad write offs on average by $500,000 monthly by restructured collections processes and create a self-pay follow up team.
  • Verified and posted account transactions, providing weekly and monthly reporting of AR aging to senior management to maintain accounting ledgers.
  • Reduced financial discrepancies by accurately managing accounting documentation.
Practice Coordinator, 08/2005 to 04/2009
Cape Cod Healthcare Inc.Plymouth, MA,
  • Managed daily operations of a multi-site, six physician medical practice
  • In conjunction with the department director, implemented process improvements and staff training as needed.
  • Led dramatic improvements in financial operations resulting in on the best medical practices within DuPage Medical Group.
  • Reduced the department charge lag for office services from 7.5 days to 0.3 days.
  • Reduced the facility-based charge lag from 17.7 to 4 days.
  • Created, collected, complied and analyzed customer satisfaction surveys to present to monthly department meeting.
  • Created, collected, complied and analyzed customer satisfaction surveys to present to monthly department meeting
  • Established strong working relationships with other departments, clinical and administrative.
Accounts Receivable Manager, 05/2005 to 08/2006
Hospital For Special SurgeryNew York, NY,
  • Responsible for managing the functions of the Accounts Receivable Department to ensure accurate balances, timely billing, and collections for Managed Care and all non-government Payers.
  • Responsible for month-end closing of billing system in accordance with company policy and timelines.
  • Responsible for timely processing of charges, adjustments, refunds, payment posting and write-offs.
  • Responsible for the supervision, hiring, and training of Accounts Receivable staff.
  • Developed tools to monitor and evaluate staff productivity.
  • Managed the non-government work of team of 15 to ensure all company and Union goals were met.
Patient Financial Service, Non-Government Accounts Manager, 08/2001 to 11/2004
Advocate Healthcare, Good SamaritanCity, STATE,
  • Developed actionable improvements for existing processes and presented to management.
  • Managed the Non-Government team of 10 employees.
  • Restructured the Non-Government team to improve collection efforts and developed follow-up tools that contributed to bringing down AR days from 80 days to 45 days within 2 years.
  • Built and maintained strong and productive relationships with key provider representatives in order to facilitate resolutions of claim issues.
Education and Training
Bachelors of Science Degree: Business Management, Expected in 02/2002
National Louis University - Wheaton, IL
GPA:

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Resume Overview

School Attended

  • National Louis University

Job Titles Held:

  • Insurance Coordinator
  • Billing Coordinator
  • Accounts Receivable Analyst
  • Practice Coordinator
  • Accounts Receivable Manager
  • Patient Financial Service, Non-Government Accounts Manager

Degrees

  • Bachelors of Science Degree

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