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Insurance Counselor Resume Example

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JC
Jessica Claire
Montgomery Street, San Francisco, CA 94105 (555) 432-1000, resumesample@example.com
Links
  • https//www.linkedin.com/in/chanellewms/
Professional Summary

Experienced Healthcare Financial and Insurance Counselor with over 8 years of experience in Patient Financial Education and Counseling. Excellent reputation for resolving problems, patient advocacy, and driving overall revenue cycle improvements. Successful at comprehensive patient education and resolving problems. Adept in patient advocacy and fostering positive patient experiences while minimizing collection efforts, increasing provider reimbursement, and maintaining compliance.

Skills
  • Account Reconciliation
  • Healthcare Benefits
  • Billing Inquiries
  • Healthcare Operations
  • Counseling and Education
  • Data Entry & Analysis
  • HIPAA Compliance
  • Medical Insurance Verification
  • Medical Terminology
  • Microsoft Office - Word, Excel, PowerPoint, Outlook,
  • Multidisciplinary Team Collaboration
  • Patient Education and Counseling
  • Patient Financial Services
  • Revenue Cycle
  • Training and Development
Work History
11/2016 to Current Insurance Counselor Davita | Athens, OH,
  • Proactively manage insurance needs for patient load of 1000+ patients across territory of 28 dialysis clinics by preparing with patients and field teammates for insurance changes, terminations and patient transfers
  • Assess uninsured admits to determine eligibility for insurance options - including state Medicaid, Medicare, Care Management Organizations, Healthcare Marketplace and Commercial plans
  • Educate patients on eligibility to maintain coverage during transition to dialysis care, such as short-term and long-term disability, FMLA, and COBRA
  • Assist patients and Social Workers with applications for eligible charitable assistance as necessary
  • Provide and review accurate and timely patient, revenue, and treatment trend reporting to Facility Administrators, Group Insurance Manager, Regional Operations Director, and Divisional Leadership
  • Analyze data and provide monthly reporting on key metrics related to patient growth and retention to senior management
12/2013 to 11/2016 Office Coordinator Lead/Insurance Specialist Holy Redeemer Health System | Runnemede, NJ,
  • Accurately inputted all patient demographic and insurance information into company's computer system using Greenway EHR to process insurance verification for up to 120 patients daily
  • Acted as Insurance Reimbursement subject matter expert, answering internal and external questions and inquiries
  • Communicated verification and authorization status updates between Infectious Disease, Radiology, Laboratory, and Primary Care departments, and potential patients to facilitate decision-making for admissions and insurance coverage
  • Conduct on-boarding, training, and coaching of new front-office employees
  • Reconcile payments collected by intake and checkout personnel by verifying against daily revenue reports
  • Resolved patient-pay obstacles prior to and upon check-in, improved front office operations and provided exceptional client support
10/2012 to 12/2013 Patient Services Representative Piedmont Ear, Nose, Throat & Related Allergy | City, STATE,
  • Accommodated patients by scheduling appointments, and establishing relationships with managed care organizations, area hospitals and insurance companies to expedite payments and resolve issues
  • Verified insurance and notify patients of in-network and out-of-network benefits and need for referral or authorization prior to service
  • Created encounters and initiate patient charts using NextGen Healthcare Information Systems
  • Processed payments at time of service, collected past due amounts, and applied to patient accounts
  • Interacted with hospitals and outpatient surgery centers to assist in establishing or maintaining credentials of 5 specialist physicians
05/2010 to 10/2012 Bank Teller III SunTrust Banks, Inc | City, STATE,
  • Accurately and efficiently processed branch banking transactions, posted payments to loans, exchanged foreign currency and initiated wire transfers
  • Promoted retail bank products and financial services while making appropriate referrals to partners in other lines of business
  • Assumed role as On-the-Job Training Facilitator for new hires, Night Depository custodian, ATM and Main Vault custodian
  • Resolved and address any client concerns, questions, or dissatisfaction in-person or over phone
  • Properly executed bank operations while limiting exposure to loss and fraud, reporting significant transactions, and responding to suspicious or fraudulent activity
  • Ranked among Top 10% of Bank Tellers in Georgia/Atlanta region, achieved by exhibiting superior behaviors to increase sales, Client Experience, and maintain Operational Excellence for 2011 and 2012
Education
Expected in 2008 Bachelor of Arts | Anthropology Georgia State University, Atlanta, GA GPA:
  • Member of Caribbean Student Association, Latin American Student Association, Black Student Alliance, Anthropology Club
  • Coursework in Quantitative Research Methods, Health & Culture, Public Health, and Medical Anthropology
Certifications
  • Certified Financial Counselor, HFMA - GA Chapter
Affiliations
  • Healthcare Financial Management Association (HFMA)
  • American Health Information Management Association (AHIMA)

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Resume Overview

School Attended
  • Georgia State University
Job Titles Held:
  • Insurance Counselor
  • Office Coordinator Lead/Insurance Specialist
  • Patient Services Representative
  • Bank Teller III
Degrees
  • Bachelor of Arts

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