Insurance Verification Specialist Resume

SUMMARY:

Talented, highly productive individual with excellent interpersonal skills, confident and poised in interactions with people at all levels
Organizational and Analytical skills seeking a career opportunity as an Accountant or in Management or related opportunity with a dynamic and progressive organization
Highly regarded for a proactive attitude and an ability to think laterally, providing ideas and solutions to complex problems
Committed to the provision of exemplary customer service
Computer literate with a good working knowledge of: MS Word/Excel Applications
Excellent Analytical and Managing Skills with the ability to communicate effectively with diverse groups of people

SKILLS

Capacity for leadership, self-starter, excellent team worker, quick learner
Customer service oriented, ability to produce quality results
Ability to audit healthcare contract pricing, billing, or revenue cycle management.
Proficient in: Windows XP, Windows 2000 and 2007, PowerPoint, Excel
Servant Leadership Development, Student Leadership Academy -
MS Office
Strong mathematic skills
French Speaking (fluently)

EXPERIENCE:

Confidential

Insurance Verification Specialist

Estimating insurance reimbursement according to contract and patients financial responsibility.
Secures pre - certifications and authorizations on all patients’ data before surgery.
Verifying benefits, authorizations and coverage of all patients. Interpreting payer contracts.
Examining patient’s documents and insurance contracts before surgery in our facility.
Evaluating fees and providing quotes for patients and doctors based on our contract with payers.
Setting up payment plan with patients based on contract with insurance companies.
Using a strong knowledge of CPT, HCPCS, ICD9/10, Revenue code and/or DRG coding practice.
Documents verification results by completing reports and logs; input data into patient database.

Confidential

Insurance Coordinator

Responsible for accurate and timely pre-registration and, insurance verification.
Secured pre-certifications and authorizations on all patients’ data.
Verified benefits and coverage of patients.
Checked patient’s information and appointment with the doctor’s office.
Calculated fees and wrote quotes for the facility to patients and doctors.
Strived for quick complaint resolution; commended by office manager for the ability to resolve problems on the first call and avoid escalation of issues.
Negotiated fees and set up payment plan with patients.
Documented verification results by completing reports and logs; input data into patient database.

Confidential

Client Services Coordinator

Verified insurance coverage, eligibility and benefits of the patient at the time of service.
Negotiated and calculated coinsurance estimates per payer contract and amount due from self-pay patients.
Completed and submitted insurance forms and electronic claims to process the claims in a timely manner as required by all third party payers.
Hands on experience with benefits verifications - making the outbound calls to insurance companies to verify benefits.
Researched and resolved any claims denials or underpayment of claims.
Experienced in commercial insurance, Medicare, Medicaid. D, B and C.

Confidential

Insurance Verification Specialist

Performs telephonic support for online authorization of routine services.
Ensures that customer issues are managed at the highest level of quality and integrity.
Provides direct support to Primary Care practices and specialty care providers regarding utilization, authorization, and referral activities.
Data entry referrals for non-complex services including inpatient and outpatient care.
Verifies eligibility of members and participating status of providers.
Becomes proficient in the use of ICD-9 and CPT codes and HIPAA regulations
Comprehensive understanding of payer guidelines and medical terminology.
Issued endorsements, renewals, cancellations leading to retention of policies.
Obtaining billing information from insurance payers, Medicaid, Medicare, PPO’s and HMO providers, leading to increased collections and reduced write-offs and denials.