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insurance specialist resume example with 5 years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
  • :
Summary
Highly motivated Sales Associate with extensive customer service and sales experience. Outgoing sales professional with track record of driving increased sales, improving buying experience and elevating company profile with target market.
Skills
  • Guest services
  • Inventory control procedures
  • Merchandising expertise
  • Loss prevention
  • Cash register operations
  • Product promotions
Experience
Insurance Specialist, 11/2022 - 05/2023
Department Of Homeland Security Omaha, NE,
  • Maintained up-to-date understanding of insurance payment practices.
  • Handled third-party insurance processing tasks to assist patients.
  • Stayed current on HIPAA regulations, benefits claims processing, medical terminology and other procedures.
  • Reviewed claims for accuracy before submitting for billing.
  • Inputted data into the system, maintaining accuracy of provider coding information and reported services.
  • Accurately processed large volume of medical claims every shift.
  • Sent clinical request and missing information letters to obtain incomplete information.
  • Based payment or denials of medical claims upon well-established criteria for claims processing.
  • Explained coverage options to potential policyholders, answering questions or concerns.
  • Monitored clients' insurance coverages to ensure changing needs were met.
  • Calculated premiums and established payment methods, receiving customer payments and issuing receipts.
Patient Access Representative - Promoted, 01/2022 - 11/2022
Adia Midway City, CA,
  • Applied HIPAA privacy and security regulations while handling patient information.
  • Verified demographics and insurance information to register patients in computer system.
  • Organized and maintained records by updating and obtaining both personal and financial information from patients.
  • Registered patients by completing face-to-face interviews to obtain demographic, insurance and medical information.
  • Obtained necessary signatures for privacy laws and consent for treatment.
  • Communicated financial obligations to patients and collected fees at time of service.
  • Applied knowledge of payer requirements and utilized on-line eligibility systems to verify patient coverage and policy limitations.
  • Assembled registration paperwork and placed identification bands on patient.
  • Processed patient responsibility estimate determined by insurance at pre-registration.
  • Verified patients' insurance and payment methods during admissions or check-in processes.
  • Explained policies, procedures and services to patients.
  • Obtained informed consent and payment documentation from patients and filed in system.
  • Organized timely and accurate referrals to help patients obtain health care services and access available resources.
Hiring and Recruiting Manager, 03/2020 - 01/2022
Preferred Home Care City, STATE,
  • Cultivated and deepened productive relationships with recruitment partners.
  • Developed and managed recruitment process, sourcing as many as [Number] candidates each year to fill key positions.
  • Tailored recruitment strategies for different types of vacancies by adjusting wording, social media paths and key websites.
  • Discussed openings with department managers, as well as desired characteristics and qualifications in candidates.
  • Established and communicated recruitment objectives and policies to employees.
  • Assisted in employee recruitment, hiring and interview processes.
  • Developed employee orientation and training programs for new hires.
  • Scheduled meetings with employees to address concerns and grievances.
  • Liaised between management and employees by relaying work information, adjustments and grievances.
  • Organized employee directories and updated individual contact information.
  • Attended conferences, workshops and special events to recruit qualified candidates for company.
Dispatch /Administrative Specialist, 04/2018 - 02/2020
Plumbing Services Of Houston City, STATE,
  • Answered and routed telephone calls and took messages.
  • Tracked and submitted employee timesheets to prepare for payroll processing.
  • Scheduled and coordinated meetings, appointments and travel arrangements for managers or supervisors.
  • Automated office operations by managing internal and external customer correspondence, record tracking and data communications.
  • Checked stock to determine inventory levels and maintain office supply products.
  • Created and revised systems and procedures by analyzing operating practices, recordkeeping systems, office layout and budgetary requirements.
  • Organized training, client meetings, team meetings and events.
  • Produced and distributed memos, newsletters and other forms of communication.
  • Composed and edited complex and sensitive correspondence, reports and documents.
  • Gathered, entered and updated data to maintain departmental records and databases.
  • Answered phone calls, provided information and connected callers to appropriate personnel.
Education and Training
Graduate: Cosmetology, Expected in 12/2020
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Aveda Institute of Baton - Rouge,
GPA:
Status -
High School Diploma: , Expected in
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Dutchtown High School - Geismar, Louisiana
GPA:
Status -
Certifications
Excellent Verbal and written Customer Services Advanced Powerpoint Advanced Word Basic Excel Cash Handling Food Preparation Advanced,

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Resume Overview

School Attended

  • Aveda Institute of Baton
  • Dutchtown High School

Job Titles Held:

  • Insurance Specialist
  • Patient Access Representative - Promoted
  • Hiring and Recruiting Manager
  • Dispatch /Administrative Specialist

Degrees

  • Graduate
  • High School Diploma

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