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Summary
Self-motivated Insurance Verification Specialist proudly offering over 13 years' experience building an understanding of medical terminology while tracking patient coverage. A poised professional with benefits explanation and ad
ministration expertise. Offering time management and interpersonal skills. Demonstrated knowledge of admissions, insurance verification and authorization processes in hospital settings. Hardworking and reliable employee with strong ability in patient services or retail manager. Offering clear and knowledgeable information to patients or retail clients .
Skills
Patient Rapport
Data Security and Confidentiality
Attention to Detail
Secure Data Practices
Coverage and Authorizations
Data Entry and Review
Customer Service
Insurance Plan Verification
Sales Techniques
Goal Setting
Performance Tracking and Evaluation
Hiring and Training
Documentation and Reporting
Team Building
Verbal and Written Communication
Shift Scheduling
Professional and Courteous
Training and Development
Experience
08/2019 to 05/2022Insurance Verification SpecialistWashington Hospital, Inc., Mary | King George, VA,
Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
Updated patient and insurance data and input changes into company computer system.
Checked documentation for appropriate coding, catching errors and making revisions.
Followed specific security rules and guidelines to protect patient medical records and payment card information.
Instructed clients on amounts covered under benefits plans in easy-to-understand terminology.
Examined claims, records and procedures to grant approval of coverage.
Retained strong medical terminology understanding in effort to better comprehend procedures.
Performed verification of Medicare coverage.
Identified important patient and demographic information.
Created and maintained accurate and confidential patient files according to regulatory mandates.
Adhered to HIPAA requirements to safeguard patient confidentiality.
Assisted with hospital admissions and paperwork.
10/2009 to 08/2019Insurance Verification SpecialistWashington Hospital, Inc., Mary | Montross, VA,
Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
Updated patient and insurance data and input changes into company computer system.
Checked documentation for appropriate coding, catching errors and making revisions.
Followed specific security rules and guidelines to protect patient medical records and payment card information.
Instructed clients on amounts covered under benefits plans in easy-to-understand terminology.
Adhered to HIPAA requirements to safeguard patient confidentiality.
Assisted with hospital admissions and paperwork.
10/2009 to 05/2022Patient Access RepresentativeLegacy Health System | Canby, OR,
Applied HIPAA privacy and security regulations while handling patient information.
Verified demographics and insurance information to register patients in computer system.
Obtained necessary signatures for privacy laws and consent for treatment.
Assembled registration paperwork and placed identification bands on patient.
Applied knowledge of payer requirements and utilized on-line eligibility systems to verify patient coverage and policy limitations.
Processed patient responsibility estimate determined by insurance at pre-registration.
Communicated financial obligations to patients and collected fees at time of service.
Dispensed appropriate information regarding facility services.
Registered patients by completing face-to-face interviews to obtain demographic, insurance and medical information.
Utilized screening tool for self-pay patients to determine payer sources, referring to financial counselors if necessary.
Reviewed eligibility responses to assess patient benefit level and prepare estimates.
Interviewed patients upon entrance to hospital, gathered appropriate information and entered data into electronic system.
Received patient inquiries or complaints and directed to appropriate medical staff members.
06/2017 to 05/2018CBO LIASIONCollege Station Medical Center | City, STATE,
Followed detailed end-of-month accounting procedures to verify proper balancing of accounts and readiness for new month.
Reviewed vendor invoices and expense reports, identifying discrepancies.
Education and Training
Expected in | General StudiesSam Houston State University, Huntsville, TXGPA:
Expected in | General StudiesSouthwest Texas State University, San Marcos, TX, GPA:
Accomplishments
Recognized while working at College Medical Center for Zero Denials for Procedures that required Approval to be performed and each account was paid by Insurance Company.
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