LiveCareer-Resume

insurance verification specialist resume example with 9+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
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 working with all types of personalities effectively. Offering dynamic organizational skills, attention to detail, and strong willingness to learn.

Accomplishments


  • During Epic go live, assisted AR and MOR staff with Epic navigation and acted as an information recourse.
  • Participate in Weekly Dashboard meetings
  • Collaborated with the training team to develop recourses for MOR staff.
  • Collaborated with Claudia Acosta, Stephanie Pinedo, Julia Pino, and Heidi Kurgat with training MORs and DORs. (assisted with Nextgen/Clearwave/Epic)
  • Assisted in Clearwave rollout - Main point of contact for payer maintenance, payer mapping and training.
  • I have worked in 3 different software's (Nextgen/Clearwave/Epic) and have been a super user in all.
  • Well versed with payer guidelines: AHCCCS, FQHC Guidelines for the proposed payment system, Medicare Guidelines for FQHC reimbursement.


Skills
  • Adaptable and Flexible
  • Collaboration and Teamwork
  • Problem Solving
  • Critical Thinking
  • Computer Proficiency
Work History
Insurance Verification Specialist, 09/2018 to Current
Snowline HospiceFolsom, CA,


  • Verify insurance eligibility for insurances for upcoming appointments by utilizing online websites or by contacting the carriers directly.
  • Maintain knowledge of contracted insurances to reduce claim denials.
  • Review patient deductibles and/or copays and enter into the billing system to ensure that patient billing is correct the first time to reduce days in AR.
  • Assist front end staff in understanding carrier websites and verification of eligibility.
  • Maintain accuracy of patient information to reduce claim denial.
  • Answers questions and maintain communication from patients, clerical staff and insurance companies.
  • Works in conjunction with the reception and AR to ensure clean billing.
  • Knowledgeable about patient font desk, business office workflow.


Medical Office Receptionist, 09/2017 to 09/2018
Envision HealthcareDade City, FL,


  • Utilizing EHR: Documented patient medical information, case histories and insurance details to facilitate smooth appointments and payment processing.
  • Managed master calendar and scheduled appointments for providers based on optimal patient loads and clinician availability.
  • Received, recorded and filed medical payments by check, cash and credit card.
  • Enhanced office productivity by handling high volume of callers per day.
  • Utilizing EHR: Aided with prescription refill requests.
  • Adhered to strict HIPAA guidelines to protect patient privacy.
  • Super User
  • Verify Insurance
Veterinary Technician, 10/2014 to 09/2017
Modern AnimalLos Angeles, CA,
  • Clerical duties: handle cash transactions, answer multiline phone, book keeping, scheduling, scanning information into patients chart, handle insurance claims, assist in transition from paper to electronic billing.
  • Managed medical intervention and therapy for animals in collaboration with veterinarian.
  • Recorded symptoms and documented medical observations to inform treatment decisions.
  • Administered medications to animals in treatment and documented changes in condition.
  • Processed new patients and updated client records with key information using standardized registration systems and encrypted databases.
  • Greeted pet owners and went over available services, outlined costs and determined special needs of animals under care.
Chiropractic Assistant, 11/2011 to 10/2013
Path MedicalTampa, FL,


  • Scheduled patient appointments for a busy chiropractic practice.
  • Input patient data into computer system using Excel, Office, Chirotouch, Eclipse, Outlook etc and checked information for accuracy.
  • Efficiently performed insurance verifications, pre-certifications and pre- authorization functions.
  • Performed clerical duties, such as word processing, data entry, answering phones and filing.
  • Sanitized, restocked and organized exam rooms and medical equipment.
  • Contacted insurance carriers to determine patients' coverage and sent invoices for services rendered.
  • Directed patients to exam rooms, fielded questions and prepared for physician examinations.
  • Called and faxed pharmacies to submit prescriptions and refills.
  • Gathered forms and copied insurance cards to collect patient information for billing and insurance filing.
  • Collected and documented patient medical information such as blood pressure and weight.


Education
: Applied Science - Radioldgy, Expected in to Pima Community College - Tucson, AZ
GPA:
GED: , Expected in 08/2010 to Woodlawn High School - Baltimore, MD
GPA:
Certifications

ARCR Certified

Super User

,
Additional Information


  • Admin for all medical verification websites. Maintain all El Rio users
  • AHCCCS Secondary – access chart added the T code and correct modifier to generate the claim for electronic submission to access
  • HRSA: Add HRSA payer, and correct insurance for specific encounter, generate claim.
  • Clearwave/RTS/Waystar: Worked closely with Leadership, IT, and front office to Trouble shoot, maintained all payers and payer mapping in clearwave and RTS. Assisted Waystar with all needed payers.
  • Generating claim files for submission to claim remidi including “DKDN conversion” for united AHCCCS plans. Upload claims to Claim Remidi, and then work errors.
  • Assisted pain management clinic to enter patient information into Epic from Nextgen.

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Resume Overview

School Attended

  • Pima Community College
  • Woodlawn High School

Job Titles Held:

  • Insurance Verification Specialist
  • Medical Office Receptionist
  • Veterinary Technician
  • Chiropractic Assistant

Degrees

  • GED

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