Pragmatic Insurance Verification Specialist touting 15 years of expertise in benefits explanation and coverage tracking. A team player with a vast knowledge of medical terms and working with all types of personalities effectively. Offering dynamic organizational skills and attention to detail.
Hardworking medical administrative brings top-notch abilities in reception and clerical work. Equipped to handle fast-paced office operations with continuous flow of patients and assignments. Meticulous in completing assignments and always ready to help team members.
Skills
Coverage and Authorizations
Insurance Terminology
Documentation and Correspondence
Medical Billing
Data Entry and Review
Customer Service
Equipment Troubleshooting and Maintenance
Managed Care
Communication and Interpersonal Skills
Payor Procedures
Order Purchasing
Teamwork and Collaboration
Work History
Insurance Verification Specialist, 09/2007 to 10/2021 U.S. Physical Therapy – Mililani, HI,
Contact with insurance carriers to discuss policies and individual patient benefits.
Reviewed, verified insurance coverage and updated 250-300 patient accounts per week.
Determined appropriateness of payers to protect organization and minimize risk.
Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
Observed strict procedures to protect sensitive patient information, medical records and payment data.
Organized and maintained patient chart filing system to promote quick data finding for staff.
Contact patients to obtain updated patient demographic and insurance information.
Experience in using OBR, GPMS, Medifax, Excel, Word and insurance payer websites.
Assisted Hospital Associates and Supervisors with registering, verifying insurance coverage and updating patient's account correctly for billing purposes.
Process and update OBR report daily, correspondences, send patient appropriate letter as per status of account.
Receptionist Administrator, 02/2007 to 09/2007 Siouxland Community Health Center – Sioux City, IA,
Answered incoming calls, directing clients to individuals addressing specific needs.
Took delivery of packages and documents, applying appropriate internal policies relating to chain of possession.
Promoted maintenance of professional and courteous customer interactions across reception personnel.
Monitored visitor access and maintained situational awareness to promote on-site security and safety.
Oversaw office equipment maintenance to support continuous and uninterrupted operations.
Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
Greeted customers and visitors in-person and via telephone calls.
Kept reception area clean and neat to give visitors positive first impression.
Answered incoming calls on high-volume, multi-line phone switchboard and pleasantly transferred callers to appropriate personnel.
Restocked supplies and placed purchase orders to maintain adequate stock levels.
Directed incoming calls to internal personnel and departments, routing to best-qualified department.
Triaged incoming calls on multi-line phone system and directed to departments based on customer needs.
Received and routed business correspondence to correct departments and staff members.
Monitored premises, screened visitors, updated logs and issued passes to maintain security.
Answered questions and addressed, resolved or escalated issues to management personnel to satisfy customers.
Handled complaints and questions, and re-directed calls to other team members.
Assisted Accounting Department with filing and organizing reports.
Medical Customer Service Representative, 01/2005 to 01/2007 Florida Home Medical Equipment – City, STATE,
Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
Answered customer telephone calls promptly to avoid on-hold wait times.
Offered advice and assistance to customers, paying attention to special needs or wants.
Responded to customer requests for products, services and company information.
Provided primary customer support to internal and external customers.
Assisted customers with setting appointments, special order requests, and arranging medical equipment pick-up.
Directed incoming calls to internal personnel and departments, routing to best-qualified department.
Collected customer feedback and made process changes to exceed customer satisfaction goals.
Used company troubleshooting resolution tree to evaluate technical problems and find appropriate solutions.
Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
Investigated and resolved customer and hospital inquiries and complaints quickly.
Exhibited high energy and professionalism when dealing with clients and staff.
Delivered prompt service to prioritize customer needs.
Met customer call guidelines for service levels, handle time and productivity.
Responded to customer requests, offering excellent support and tailored recommendations to address needs.
Promoted superior experience by addressing customer concerns, demonstrating empathy and resolving problems swiftly.
Developed highly empathetic client relationships and earned reputation for exceeding service standard goals.
Provided excellent customer care by responding to inquiries, requests, assisting with medical equipment questions.
Provided excellent customer care by responding to requests, assisting with product selection and handling ordering functions.
Collaborated with staff members to enhance customer service experience and exceed team goals through effective client satisfaction rates.
Managed timely and effective replacement of damaged or missing equipment.
Sought ways to improve processes and services provided.
Increased efficiency and team productivity by promoting operational best practices.
Enhanced productivity levels by anticipating needs and delivering outstanding support.
Recorded actions taken, issues resolved and provided information to effectively manage customer accounts.
Facilitated medical and hospital discharge orders and completed accurate to meet aggressive deadlines.
Assessed caller accounts to determine health coverage benefits, identify service needs and resolve issues.
Resolved patient order and medical equipment issues over phone fifty customers daily.
Assisted Case Manager with medical discharge order process and delivery status.
Assisted dispatch department with providing patients ETA for medical equipment delivery order.
Education
No Degree: Business Administration And Management, Expected in Miami Lakes Educational Center And Technical College - Hialeah, FL GPA:
Studied from 1995-1997
No Degree: Computer Integrated Manufacturing, Expected in Miami Dade College - Miami, FL GPA:
Studied from 1990-1994
High School Diploma: , Expected in Miami Carol City Senior High School - Miami Gardens, FL GPA:
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School Attended
Miami Lakes Educational Center And Technical College
