Insurance Verification Specialist 3 Resume Example

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Jessica Claire
  • , , 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
Professional Summary

Pragmatic Insurance Verification Specialist touting 5 years of expertise in benefits explanation and coverage tracking. A team player with a vast knowledge of medical terms and the ability to work with all types of personalities effectively. Offering dynamic organizational skills and attention to detail. I enjoy working in a fast paced, highly motivating position where I can assist internal and external customers while challenging and expending my knowledge while understanding the task at hand. I’m seeking a promising position that will utilize my skills and offer the chance for advancement as well as allow me the opportunity to gain additional skills and experience.

  • Understanding of medical terms
  • Insurance coverage verification
  • Patient contact
  • Data integrity
  • Prior authorization processing
  • MS Office
  • Organization and Time management
  • Teamwork
  • Verbal and written communication
  • Microsoft Office
  • Data management
  • Good listening skills
  • Good telephone etiquette
Work History
Insurance Verification Specialist 3, 09/2017 to Current
Merchants BankSaint Charles, MO,

Utilizes all available resources to obtain and enter insurance coverage information for ordered services into patient s file. Verifies patient insurance coverage of medications, administration supplies and related pharmacy services. Completes the Prior Authorization process. Completes a full Medical Verification for all medications, administration supplies and related pharmacy services. Notifies patients, physicians, practitioners and/or clinics of any financial responsibility of services provided and requested services that are not provided by the facility. Facilitates pharmacy or major medical claims with insurance companies and practitioner offices and investigates and facilitates prior authorization any other insurance rejections. Places outbound calls to patients or physicians offices to obtain additional information needed to process the script or to notify of delay in processing script. Manages inbound calls on the Insurance line from patients, clients, physicians, practitioners and clinics regarding inquiries about services provided, financial responsibility and insurance coverage.

HIM Anaylist 2 & Scheduler , 08/2016 to 08/2017
Baylor Scott & WhiteCity, STATE,

HIM Analyst 2 - Assists with answering and handling incoming phone call requests. Collecting and delivering mail. Greet customers to the department and refers them to appropriate personnel. Processes medical record documentation to include prepping, scanning/importing, indexing, basic quality control, and archiving for the purposes of record retention. Provides clerical support for coding documentation issues. Works closely with direct Supervisor or Manager to ensure operational needs of facility are met.

I transferred departments in between time.

Scheduler - Collection. Answering incoming calls regarding patient needs & scheduling appointments. Register patients/demographics. Scan medical records. Upload radiology disc reports. Doctor charges. Discharge patients. Faxing and receiving orders.

Medical Record Tech 1 & Insurance Verification , 11/2014 to 08/2016
Texas OncologyCity, STATE,

Medical Record Tech 1 - Gathers patient information by collecting demographic information from a variety of sources; interacting with registration areas and physicians offices, retrieving information from automated printer. Retrieves medical records by following chart-out procedures, documenting reasons charts cannot be retrieved for statistical and follow-up purposes. Delivers charts to assigned areas of the hospital by following established routing procedures. Maintains quality results by following hospital standards. Faxing dictation out to other physicians. Shredding charts. Phone operator (inbound calls). Scheduling patients. Sub for check in desk.

I transferred departments in between time.

Insurance Verification Specialist - Monitors and update accounts status. Collection calling patient for payments on bills. Recommends accounts for collection or write-off. Contacts patients to secure past due balances, verifies patient demographics and insurance providers,updates information in systems,and documents conversations. Answers patient payment, billing, and insurance questions and resolves complaints. Performs other duties as requested or assigned. Data Entry. Completing co-pay log. Duplicate appointments from Athena to Misys.

Customer Service Representative, 07/2013 to 11/2014
ConnectionsCity, STATE,

Answer incoming calls from our customers on issues related to benefit eligibility questions and prescriptions inquiries. Help guide and educate customers on their prescription benefits, use of plan, formulary, premiums and status of orders, and claims or inquiries Identify issues and communicate solutions and steps to customers, pharmacies, and physicians with prescription orders and reorders. Collecting payment. Escalate drug related calls as appropriate to licensed pharmacist for resolution. Enter
new prescription orders into system. Meet the performance goals established for the position in the areas of: efficiency, call quality, customer satisfaction, first call resolution and attendance.

High School Diploma: , Expected in 05/2013
Skyline High School - Dallas, TX

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Resume Strength

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  • Personalization
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Resume Overview

School Attended
  • Skyline High School
Job Titles Held:
  • Insurance Verification Specialist 3
  • HIM Anaylist 2 & Scheduler
  • Medical Record Tech 1 & Insurance Verification
  • Customer Service Representative
  • High School Diploma

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