Sr. Insurance Specialist Resume Houston, TX - Hire IT People

SUMMARY

I’m experienced with account reconciliation, account coding and ledger strategies. I am Well - versed in matching of PO’s, entering payable invoices and validating processing authorizations for the same. I ensure completeness and accuracy of billing data. I am proficient in clerical tasks; file cataloging, photocopy and document scanning. I Find claims processing issues and notify Supervisor and/or Manager minimizing delay in claims processing.
I am familiar with month end closing and report filing protocols. I have a solid mathematical background. With the ability: to sort, check, count, and verify numbers. I have the ability to multi-task, prioritize solve problems and work under stick deadlines. IExpedite and increase payment of insurance medical claims by contacting third party payors and patients. I am able to listen and comprehend communicate (written and verbal), excellent grammar, spelling and proof reading skills and follow-up effectively with all staffing levels, clients and or customers. I am an energetic self-starter with the ability to work independently.
I demonstrate good common sense and sound judgment flexibility to adapt to all situations and work varied hours; possibly work weekends or evenings to perform at high levels in a fast paced ever-changing work environment and the ability to anticipate work needs and follow through with minimum direction

TECHNICAL STRENGTHS

PROFESSIONAL EXPERIENCE

Sr. Insurance Specialist

Confidential, Houston, TX

Responsibilities:

Verified insurance benefits by telephone and online timely and accurately
Maintain and update patient account with current benefit information
Utilized Epic, McKesson, IDX, and STAR effectively for claim billing
Check claim status for payment and possible appeal
Interacted daily with third party vendors and patients to their claim related queries
Coordinated effectively with the project manager and hospital liaison regarding any pending payment claims issues
Research researches cash receipts, payment posting and claim fee schedule
Generate weekly billed claim report in excel for project manager

Bad Debt Collector

Confidential, Houston, TX

Responsibilities:

Retrieve and review EOB an assessed each account and take the appropriate actions necessary to obtain complete adjudication of the patients claim.
Assist patients and their insurance carriers to resolve open account balances
Researches and applies unallocated cash oversees client trust accounts, accounts receivable write-offs and payment reversals
Maintain telephone and personal contact with attorneys, staff and vendors on receivable matters as directed by manager
Assist in financial management and analysis, as requested, organizes and maintains retention files for required period of time.
Learned to interpret, process, implement, and manage necessary account management principles that are in accordance with PFS vision and goals
Learn current year credits and deduction per IRS code guidelines
Assessed clients income, life events and prior year tax return for possible deductions with client
Prepare and file annual state and federal tax form 1040’s, 1099’s and schedule SE

Exc. Admin Assistant

Confidential, Houston, TX

Responsibilities:

Created vendor filing system and Maintained records in excel and quick books
Responsible for A/P and A/R duties
Performed Bookkeeping in QuickBooks
Prepared agenda for board of director’s meeting as per guideline of executive director
Recorded minutes of board meetings
Maintained schedule and arranged travel for the Executive Director
Maintained inventory including ordering and distributing supplies
Liaison between the company and community based organizations and local political officials
Assisted fund raising consultants and foundations to develop funding for a building project
Maintain donor database