Pragmatic Insurance Verification Specialist touting over 20 years of expertise in benefits explanation and coverage tracking. A team player with a vast knowledge of medical terms and working with all types of personalities effectively. Offering dynamic organizational skills and attention to detail.
Work History
Insurance Verification Specialist
5 Years 1 Month
Home Care Delivered | 10.2021 - Current
Update patient files with benefits and appropriate flags
Notate patient accounts with payer response, and reassign order to the correct department and/or person
Work independently and/or collaboratively to answer inquiries and resolve issues within regulatory and company requirements to ensure customer retention and satisfaction, escalating issues whenever appropriate
Collaborate with team members to resolve discrepancies in insurance verification, ensuring proper billing practices.
Demonstrate a high level of professionalism and attention to detail in all aspects of insurance verification specialist role, consistently exceeding performance expectations.
Contribute to company's bottom line by reducing write-offs due to incorrect or outdated insurance information through diligent verification efforts.
Contribute to departmental goals by consistently meeting or exceeding established performance metrics related to productivity, quality, and service excellence standards.
Care Management Support Assistant 2
7 Months
Humana | 03.2021 - 10.2021
Provided Medicare Advantage members access to special clinical programs, which were designed to meet their clinical needs
Initiated engagement and connected members with appropriate care team personnel including care managers and customer service when needed
Demonstrated and ongoing enthusiastic and passionate presence over the telephone
Mentored senior management of care management support assistant everyday processes
Exercised effective verbal and written communication, along with active listening skills, organization and time management
Investigated and identified providers or stakeholders in order to obtain missing or invalid member information
Utilized Microsoft Teams, Microsoft OneNote, Skype, Clinical Guidance Exchange and Avaya One-X Agent Software for daily tasks.
RCS Senior Analyst - Patient Estimates
1 Year
Indiana University Health | 08.2018 - 08.2019
Provided individualized prospective patient estimates related to specific healthcare services provided at Indiana University entities
Performed independent research in conjunction with a certain estimate request
Maintained a log of all requests to be used for productivity and quality assurance purposes
Navigated through multiple computer systems to provide estimates (Cerner CDM Viewer, Med Assets, IDX, Passport, Insurance Websites, and Web Based Insurance Portals (Availity), Word Excel and Outlook
Protected and maintained the confidentiality of all patient health information
Promoted a customer focused service delivery environment
Gained general knowledge of HCPCS, CPT, and ICD codes.
Patient Account Specialist
3 Years 5 Months
Heritage Medical Associates | 11.2014 - 04.2018
Obtained patient estimates for GI and OB/GYN patients
Performed collection of accounts with insurance and private pays
Established payment plans for patients
Assisted customer service and account receivable departments with billing problems and concerns
Posted balances on patient accounts for payments/non payments
Posted insurance payments to accounts, as well as adjustments for credits/debits and account write offs
Utilized proficiency in Allscripts PM, Allscripts Pro EHR, and Allscripts Prenatal systems
Mentored and supported new employees through email, group and individual training.
Medical Office Specialist
2 Years 3 Months
Skyline Medical Group (HCD) | 06.2012 - 09.2014
Greeted and interacted with patients to provide information, answer questions and assist with appointment scheduling.
Scheduled patients, completed and input intake forms, collected payments, performed insurance verifications and prior authorizations
Scanned the patient's insurance card and identification into the practice management system
Utilized proficiency in eClinicalWorks EHR
Mentored and motivated new employees for front office operations.
Facilitated effective communication between patients, healthcare providers, and insurance companies for optimal care coordination.
Trained newly hired administrative staff members on office policies, procedures, and best practices, fostering a supportive team environment.
Coordinated patient scheduling, check-in, check-out and payments for billing.
Reconciled daily payments received and prepared deposits for smooth office finances.
Patient Access Registration
8 Years 8 Months
Parallon (HCA) | 10.2003 - 06.2012
Performed patient registration upon hospital admission and outpatient procedures using Meditech software
Verified patient insurance with Passport Onesource software for both medical and behavioral health patients for multiple hospitals
Consulted with clinical staff to organize and schedule admission of patients
Scanned patient information into electronic health records
Collected patient insurance responsibility (copays, deductible, out of pocket and coinsurance)
Provided financial counseling to patients and/or patient representatives as needed
Trained and guided new employees on organization procedures and departmental programs.
Education
Diploma in Medical Office Specialist
Kaplan Career Institute | Nashville, TN | 01.2008
Diploma in Business Technology
Tennessee College of Applied Technology | Nashville, TN | 01.1999
Skills
Attention to Detail
HIPAA Compliance
Insurance Coverage Verification
Data entry proficiency
Communication and Interpersonal Skills
Electronic Medical Records
Medical Terminology
Accuracy and Precision
Financial Counseling
Insurance Verification
Customer Service
Collaborative relationships
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference
Work Type
Full Time
Location Preference
Remote
Important To Me
Company CultureWork-life balanceCareer advancementPaid sick leave401k matchPaid time offFlexible work hoursWork from home optionPersonal development programsHealthcare benefitsTeam Building / Company Retreats
"The real test is not whether you avoid this failure, because you won’t. It’s whether you let it harden or shame you into inaction, or whether you learn from it; whether you choose to persevere."