Insurance Verification Specialist resume example with 16+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • H: (555) 432-1000
  • C:
  • Date of Birth:
  • India:
  • :
  • single:
Professional Summary

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.

  • 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 - 10/2021
U.S. Physical Therapy Milford, DE,
  • 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 - 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 - 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.
No Degree: Business Administration And Management, Expected in
Miami Lakes Educational Center And Technical College - Hialeah, FL

Studied from 1995-1997

No Degree: Computer Integrated Manufacturing, Expected in
Miami Dade College - Miami, FL

Studied from 1990-1994

High School Diploma: , Expected in
Miami Carol City Senior High School - Miami Gardens, FL
Spanish :
Native or Bilingual:
Negotiated :

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Resume Overview

School Attended

  • Miami Lakes Educational Center And Technical College
  • Miami Dade College
  • Miami Carol City Senior High School

Job Titles Held:

  • Insurance Verification Specialist
  • Receptionist Administrator
  • Medical Customer Service Representative


  • No Degree
  • No Degree
  • High School Diploma

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