Livecareer-Resume
Jessica
Claire
resumesample@example.com
(555) 432-1000,
, , 100 Montgomery St. 10th Floor
:
Summary

Seasoned Medical Insurance Specialist with excellent planning and problem solving abilities. Offering 20+ years of experience and a willingness to take on any challenge. Organized, driven and adaptable professional with successful history managing high caseloads in fast-paced environments.

Skills
  • Insurance claims management
  • ICD-10 coding
  • Insurance collections
  • Insurance claims
  • Front desk operations
  • Referral verification
Education and Training
Jordan Vocab Columbus, GA, Expected in 01/1993 – – GED : - GPA :
Experience
Atria Senior Living Group, Inc. - Private Child Caregiver
Fort Worth, TX, 06/2020 - Current
  • Organized and planned age-appropriate lessons involving reading, crafts, music and movement.
  • Balanced schedules to provide optimal rest, play and educational periods.
  • Enforced rules to teach manners and maintain safe environment.
  • Helped prepare meals, snacks and refreshments for children and accounted for individual dietary needs and restrictions.
  • Discussed new developments, misbehavior and concerns with parents or guardians.
  • Secured indoor and outdoor premises to protect children under care.
  • Led children in tidying up, handwashing and toileting to teach responsibility.
  • Delivered direct, supervised care to groups of children between ages 1 and 8.
International Bancshares Corp - Customer Service Representative
Lawton, OK, 06/2019 - 06/2020
  • Informed customers about billing procedures, processed payments and provided payment option setup assistance.
  • Documented conversations with customers to track requests, problems and solutions.
  • Asked probing questions to determine service needs and accurately input information into electronic systems.
  • Fielded customer complaints and queries, fast-tracking them for problem resolution.
  • Retained strong medical terminology understanding in effort to better comprehend procedures.
  • Handled billing related activities focused on medical specialties.
  • Instructed clients on amounts covered under benefits plans in easy-to-understand terminology.
  • Followed specific security rules and guidelines to protect sensitive data, including patient medical records and payment card information.
  • Checked documentation for appropriate coding, catching errors and making revisions.
  • Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
  • Examined claims, records and procedures to grant approval of coverage.
  • Updated patient financial information to promote accurate record keeping.
Kaiser Permanente - Office Assistant
Honolulu, HI, 02/2016 - 08/2018
  • Coordinated vendors, timelines and budgets for events.
  • Selected décor and event materials fitting clients' requests and vision.
  • Assessed event success and identified improvement areas through client feedback.
  • Initiated negotiations with vendors and subcontractors to meet event budget.
  • Designed and maintained spreadsheets documenting vendor, facility and guest information.
  • Oversaw event logistics, venue scheduling and accommodations.
  • Directed florists, photographers, musicians and ceremony participants during pre-ceremony, ceremony and post-ceremony events.
  • Hosted large groups by engaging with attendees during annual events.
  • Planned, coordinated and executed weddings and special events.
Arkansas Urology - Insurance Specialist
Pine Bluff, AR, 01/2012 - 02/2017
  • Stayed current on HIPAA regulations, benefits claims processing, medical terminology, and other procedures.
  • Evaluated pending claims to identify and resolve problems blocking auto-adjudication.
  • Accurately processed large volume of medical claims every shift.
  • Inputted data into the system, maintaining accuracy of provider coding information and reported services.
  • Reviewed claims for accuracy before submitting for billing.
  • Reviewed administrative guidelines whenever questions arose during processing of claims.
  • Based payment or denials of medical claims upon well-established criteria for claims processing.
  • Tracked differences between plans to correctly determine eligibility and assess claims against benefits and data entry requirements.
  • Sent clinical request and missing information letters to obtain incomplete information.
  • Reviewed received payments for accuracy and applied to intended patient accounts.
  • Maintained up-to-date understanding of insurance payment practices.
  • Filed and submitted insurance claims.
  • Handled third-party insurance processing tasks to assist patients.
  • Performed routine quality assurance audits to promote data integrity.
  • Expertly assigned charges and payments for medical procedures.
  • Assessed medical codes on patient records for accuracy.
  • Verified final claim submissions by comparing account charges with documentation.
  • Documented and filed patient data and medical records.
  • Recorded, stored and reported medical coding information to create statistics of healthcare encounters.
  • Coordinated communications between patients, billing personnel and insurance carriers.
  • Contacted insurance providers to verify insurance information and obtain billing authorization.
  • Organized information for past-due accounts and transferred to collection agency.
  • Reviewed all claims for accurateness and appropriateness.
  • Handled billing for full complement of practice providers.
  • Completed and submitted appeals for denied claims.
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
  • Used software system to manage provider schedules and keep calendar organized practice.
  • Used various health record indexes and storage retrieval systems to manage medical billing.

By clicking Customize This Resume, you agree to our Terms of Use and Privacy Policy

Disclaimer

Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.

How this resume score
could be improved?

Many factors go into creating a strong resume. Here are a few tweaks that could improve the score of this resume:

89Good

resume Strength

  • Formatting
  • Length
  • Measurable Results
  • Personalization
  • Strong Summary
  • Target Job
  • Typos

Resume Overview

School Attended

  • Jordan Vocab

Job Titles Held:

  • Private Child Caregiver
  • Customer Service Representative
  • Office Assistant
  • Insurance Specialist

Degrees

  • GED

By clicking Customize This Resume, you agree to our Terms of Use and Privacy Policy

*As seen in: