LiveCareer-Resume

insurance verification specialist resume example with 13+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
Summary

Proven expertise in insurance products, service and customer needs. Familiar with analyzing documentation, liaising between parties and handling both routine and complex issues each day. Identifies and resolves concerns while promoting new products and meeting sales objectives.

Skills
  • Client Intake
  • Patient interviewing skills
  • Appointment confirmation
  • Medical filing
  • Recording histories
  • Medical billing
  • Reliable and trustworthy
  • Decision-making
  • Leadership
  • Multitasking
  • Communication
  • Problem resolution
  • Clerical
  • Fluent in Spanish
  • Patient interviewing skills
  • Healthquest, EMR, Cedaron software expert
  • Scheduling appointments
  • Office administration
  • Typing 50 WPM
  • Flexible
  • Microsoft Office
  • Data management
  • Regulatory requirements
  • Schedule management
  • Records management and maintenance
  • Health information systems
  • Eligibility verification
  • Conflict mediation
  • Data entry
  • Patient relationship management
  • Claims processing
Experience
Insurance Verification Specialist, 01/2012 to 09/2020
Refresh Mental HealthNoblesville, IN,
  • Conducted patient intake interviews to collect medical information and insurance details.
  • Scheduled/Rescheduled and confirmed patient appointments for Home Health Services.
  • Managed and directed patient Intake functions Registering/Admitting/Discharging patients in Cradle Mrx.
  • Accessed Insurance on-line tools and/or by phone to verify that patients had proper insurance coverage prior to any Home Health Services or any discipline appointment.
  • Initiated requests for Authorization to maximize reimbursements for the company.
  • Checked documentation for appropriate coding, catching errors and making revisions.
  • Updated all patient and insurance data regularly and carefully inputted changes into company's computer system.
  • Processed and billed HCFA 1500 or UB-92 for Medicare, Medicaid and Managed Care insurances, using ICD-10 CM and CPT coding.
  • Tracked claims to ensure timely payment and for outstanding claims.
Patient Registration Representative, Jul2010 to Sep2011
Children's Of AlabamaHomewood, AL,
  • Facilitated access to UTMB services for new and returning patients,
  • Scheduled and confirmed patient appointments for UTMB Katy Clinic.
  • Conducted patient intake interviews to collect demographics and medical insurance information to Pre-Register/Register patients in Epic System.
  • Communicating with insurance carriers on-line or by phone relating to insurance coverage, out-pocket/deductible. Obtaining all prior authorizations as appropriate, based on insurance plans. contracts/guidelines and documents in the system per policy and procedure.
  • Screening patients for financial responsibility and possible cash collections. Setting up payments
  • Notifying patients of insurance limitations or potential arrangements/collecting/posting estimated portions due at time of service.
  • Identifying non-resource patients for possible eligibility for government resource and/or UTMB charity programs.
  • Communicated with patients, about referral sources and the treatment team regarding patient access and financial issues.
  • Answered extensive daily phone calls to schedule appointments and address patient inquiries.
  • Charting and updating medical records to make sure were in compliance with Medicaid and Managed Care Insurances.
  • Created and maintained accurate and confidential patient files according to regulatory mandates.
  • HIPPAA regulations.
Patient Access Representative, Sep2006 to May2010
Morton Comprehensive HealthTulsa, OK,
MrxMrx
  • Scheduled/Rescheduled patients in Health Quest/Cedaron system and updated pertinent details related to insurance, payment histories and personal or confidential information.
  • Conducted patient intake interviews to collect medical information and insurance details.
  • Verified demographics and insurance information coverage to register patients in computer system prior to any appointment scheduling.
  • Performed insurance verification, pre-certification and pre-authorization.
  • Processed/Collected/Posted patient's payments for therapy appointments.
  • Updating medical records in EMR software. Assembled registration paperwork and printing identification labels on patients registration appointment.
  • Obtained necessary signatures for privacy laws and consent for treatment.
  • Accessed patient information through variety of office software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations.
Education and Training
Associate of Arts: Computer Applications And Technologies, Expected in 06/2004
Los Angeles Valley College - Van Nuys, CA
GPA:
: Medical Terminology , Expected in 08/2005
Los Angeles Valley College - Van Nuys, CA
GPA:
: Medical Insurance And Billing & Coding, Expected in 12/2008
Katy ISD District School - Katy, TX,
GPA:
: Records And Information Management, Expected in 06/2003
Los Angeles Valley College - Van Nuys, CA
GPA:
: CPT Outstanding Reporting , Expected in 12/2008
Katy ISD District School - Katy, TX,
GPA:

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Resume Overview

School Attended

  • Los Angeles Valley College
  • Los Angeles Valley College
  • Katy ISD District School
  • Los Angeles Valley College
  • Katy ISD District School

Job Titles Held:

  • Insurance Verification Specialist
  • Patient Registration Representative
  • Patient Access Representative

Degrees

  • Associate of Arts

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