LiveCareer-Resume

insurance specialist resume example with 8+ years of experience

Jessica Claire
  • Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
Summary
A highly regarded, well-qualified self-starter currently seeking a challenging career change into a leadership role. Recognized for expertise in managing finances, personnel, operations, and policies/procedures. Recognized for a willingness to take on added responsibility to meet tight deadlines.
Highlights
COMMUNICATION ~ CONFLICT RESOLUTION ~ NEGOTIATION ~ ORGANIZATION ~ TEAM LEADERSHIP ~ RECRUITMENT ~ TALENT DEVELOPMENT ~ CUSTOMER RELATIONS ~ INVENTORY CONTROL ~ CUSTOMER CENTRIC ~ FLEXIBILITY ~ VISIONARY ~ MARKETING STRATEGIES ~ CRITICAL/CREATIVE THINKING ~ ACTIVE LISTENING ~ DECISION MAKING ~ TRUSTED KEY HOLDER ~ CREATIVE PROBLEM SOLVING ~ CLIENT RELATIONS ~ CREDIT CARD PROCESSING ~ MEDICAL TERMINOLOGY ~ MEDICAID STATUTES/REGULATIONS ~ PATIENT REFERRALS ~ COMMERCIAL/PRIVATE INSURANCE CARRIERS ~ INSURANCE BENEFITS ~ ATTENTION TO DETAIL ~ FAST PACED ENVIRONMENTS ~ MULTITASKING ~ PRIORITIZATION ~ STRONG WORK ETHIC
Experience
INSURANCE SPECIALIST, 03/2015 to Present
Lithia MotorsCoraopolis, PA,
  • Accountable for verifying patient eligibility and claims status from multiple insurance agencies.
  • Researched and acquired extensive knowledge of multiple insurance coverages/policies/exclusions.
  • Expertise in helping to keep the rates of denial low.
  • SELECTED CONTRIBUTION:.
  • Able to work on multiple project simultaneously, while dealing with multiple insurance companies and adhering to policies.
MARKETING DIRECTOR & OFFICE MANAGER, 03/2013 to 03/2015
HIGHLAND RANCH FAMILY MEDICINECity, STATE,
  • Verified patient eligibility and claims status with insurance agencies.
  • Coordinated daily operations including employee management, inventory management, customer service, and accounting/payroll services.
  • Organized the department in accordance with administrative guidelines in order to provide specified nursing services to meet the legal, organizational, and medical staff guidelines.
  • Obtained documents, clearances, certificates, and approvals from local, State and Federal agencies; analyzed departmental documents for appropriate distribution/filing.
  • Completed claims paperwork, documentation, and system entry.
  • Assisted in medical chart maintenance and electronic medical record maintenance (filing, Op Reports, test results); maintained strict patient and physician confidentiality.
  • Identified and corrected inconsistencies, deficiencies, and discrepancies in medical documentation.
  • Managed a multiline phone system; greeted and directed all patients.
  • Coordinated luncheons with Pharmaceutical Representatives.
  • SELECTED CONTRIBUTIONS: Increased revenue and number of patients by 40%.
  • Implemented marketing strategies which resulted in growth of patient base.
  • Researched newly identified diagnoses and/or medical procedures to expand skills and knowledge.
  • Complied with applicable laws and regulations and ensured that the facility adhered to Medicare/Medicaid rule and regulations.
  • Encouraged creative thinking, problem solving, and empowerment as part of the facility management group to improve morale and teamwork.
MARKETING DIRECTOR & BUSINESS MANAGER, 06/2012 to 06/2014
FERRER ASSISTED LIVING FACILITIESCity, STATE,
  • Managed the overall operation of nursing services/patient care including financial management, QA, patient care, safety risk management, teammate satisfaction, quality index scores, and facility maintenance.
  • Confirmed accurate completion of forms/reports for the admission, transfer and/or discharge of each resident.
  • Developed departmental goals, objectives, standards of performance, policies, and procedures.
  • Recruited, hired, and managed employees; organized the department in accordance with administrative guidelines in order to provide specified nursing services to meet legal, organizational, and medical staff guidelines.
  • Established/maintained systems that safely met resident needs.
  • Established/oversaw implementation of an effective budgeting and accounting system that improved efficiency and reduced costs.
  • Investigated and reported special incidents, events, and complaints to the Health Department.
  • Conducted monthly patient case conferences, in services, and staff meetings to educate staff and facilitate communication.
  • Certified that equipment and supplies were properly maintained for quality patient care and safety.
  • Managed/directed fiscal operations, including planning budgets, authorizing expenditures, accounting, establishing service rates, and coordinating financial reporting.
  • Promoted the properties and maintained full occupancy.
  • Facilitated organized record retrieval/access by maintaining filing system for both in-house and discharged residents.
  • Established staff schedules/assignments based on facility needs and equipment availability.
  • SELECTED CONTRIBUTIONS: Increased revenues by 55% by doubling the number of private pay residents.
  • Successfully obtained the State-required Assisted Living Administrator license.
  • Developed a system of staff communication that ensured proper implementation of treatment plans and comprehensive patient care.
  • Facilitated staff education on State/Federal statutes, rules, and regulations governing home care services.
  • Consistently maintained/improved the company's reputation and positive image in served markets.
  • Participated in facility surveys and inspections conducted by authorized governmental agencies.
  • Monitored Infection Control.
  • Critical Incidents, Risk Management, and Quality Improvement plans.
Education
Bachelor of Science: Business and Healthcare Administration/Information Systems, Expected in
COLORADO CHRISTIAN UNIVERSITY - LAKEWOOD, CO
GPA:
Business and Healthcare Administration/Information Systems
Certified, Microdermabrasion/Chemical Peels: , Expected in
COLLEGE OF INTERNATIONAL ESTHETICS - ARVADA, CO
GPA:
Licensed, CNA
: , Expected in
ARAPAHOE COMMUNITY COLLEGE - LITTLETON, CO
GPA:
Skills
accounting, accounting system, administrative, Assisted Living, ATTENTION TO DETAIL, BENEFITS, budgeting, budgets, CNA, conferences, CONFLICT RESOLUTION, creative thinking, CREATIVE PROBLEM SOLVING, CREDIT, CUSTOMER RELATIONS, CLIENT RELATIONS, customer service, DECISION MAKING, documentation, facility maintenance, facility management, FAST, filing, financial management, financial reporting, forms, home care, image, Infection Control, INSURANCE, inventory management, INVENTORY CONTROL, TEAM LEADERSHIP, legal, LISTENING, employee management, marketing strategies, medical record maintenance, MEDICAL TERMINOLOGY, meetings, access, MULTITASKING, NEGOTIATION, nursing, organizational, patient care, payroll, phone system, policies, problem solving, quality, Quality Improvement, QA, RECRUITMENT, Risk Management, safety, surveys, teamwork, treatment plans

By clicking Customize This Resume, you agree to our Terms of Use and Privacy Policy

Your data is safe with us

Any information uploaded, such as a resume, or input by the user is owned solely by the user, not LiveCareer. For further information, please visit our Terms of Use.

Resume Overview

School Attended

  • COLORADO CHRISTIAN UNIVERSITY
  • COLLEGE OF INTERNATIONAL ESTHETICS
  • ARAPAHOE COMMUNITY COLLEGE

Job Titles Held:

  • INSURANCE SPECIALIST
  • MARKETING DIRECTOR & OFFICE MANAGER
  • MARKETING DIRECTOR & BUSINESS MANAGER

Degrees

  • Bachelor of Science
  • Certified, Microdermabrasion/Chemical Peels

By clicking Customize This Resume, you agree to our Terms of Use and Privacy Policy

*As seen in:As seen in: