Adrean Burley
Ft worth,TX
Summary
Friendly Insurance Verification Specialist promoting a background in keeping sensitive patient data confidential while maintaining knowledge of Medicaid and private policy benefits. Possessing great relationship building and communication skills. Looking to tackle new challenges with a company that values dynamic skills and a strong work ethic.
Overview
7
7
years of professional experience
Work History
Insurance Verification Specialist
Walgreens Boots Alliance
DALLAS, TX
08.2017 - 07.2024
- Developed a working knowledge of insurance plans, including Medicare and Medicaid regulations and requirements.
- Analyzed complex health plan contracts to determine benefit coverage levels for services rendered.
- Reviewed medical records to ensure accuracy of required information needed for pre-authorization requests.
- Responded promptly to customer inquiries regarding their benefits and eligibility status.
- Verified patient eligibility for insurance coverage by contacting insurance carriers and obtaining the necessary authorization numbers.
- Monitored changes in government regulations affecting healthcare reimbursement systems.
- Ensured that the most current version of provider contracts were stored in the database.
- Identified discrepancies in patient's insurance coverage or benefits, ensuring accuracy of data entered into system.
- Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
- Instructed clients on amounts covered under benefits plans in easy-to-understand terminology.
- Developed and maintained professional relationships with insurance representatives.
- Implemented process improvements to enhance efficiency and accuracy of insurance verification.
- Updated patient accounts with insurance verification information to ensure accurate billing.
- Navigated through multiple online systems to obtain documentation.
- Determined estimated self-pay portion by calculating charges, co-insurance and deductibles.
- Managed multiple tasks and priorities in a high-volume, fast-paced environment.
- Collaborated with healthcare providers to communicate insurance coverage and authorization details.
- Contacted patients to confirm demographic information and communicate financial responsibilities.
Education
KAPLAN COLLEGE
Fort Worth, TX09-2012
Skills
- Medical Terminology
- Attention to Detail
- Electronic authorization processing
- Statement preparation
- Database Management
- Medical Billing
Timeline
Insurance Verification Specialist
Walgreens Boots Alliance
08.2017 - 07.2024
KAPLAN COLLEGE