A highly motivated and experienced Health Insurance specialist with an in-depth knowledge of the insurance industry. Possessing excellent customer service, communication, and problem-solving skills, as well as the ability to work collaboratively and independently.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Medical Insurance Specialist
Baylor Scott & White
06.2021 - 09.2023
Performed financial clearance of patient accounts by timely insurance eligibility verifications.
Obtained prior authorization for HMO policies.
Scheduled patients appointments and procedures when needed. while coordinating with several offices on availability and scheduling needs/requirements.
Interpreted complex payer coverage information including network participation status, limited plan coverage and inactive benefits.
Coordinated the submission of documents from physicians to payer for authorization needs.
Calculated accurate patient financial responsibility.
Workers Compensation Coordinator
Madsen Orthopedics
11.2019 - 05.2020
Submitted requests for in office and hospital injections.
Answered phones and routed to appropriate department.
Submitted all supporting documents to corresponding insurance companies requesting for prior approval of procedures.
Communicated with adjusters and updated patients on any changes to work status.
During clinic days, i performed all check out duties which included scheduling follow up visits, collecting copayments, and any other requests from physician and staff.
Intake Coordinator
Bone and Joint Orthopedics
08.2019 - 01.2020
Provided excellent customer service to patients, family members, and healthcare providers during the intake process.
Maintained strict confidentiality of patient information, adhering to HIPAA guidelines and company policies.
Reduced errors in patient data entry with thorough verification processes and attention to detail.
Completed intake assessment forms and filed clients' charts.
Office Manager
America's Car-Mart
01.2018 - 01.2019
Handled sensitive information with discretion, maintaining confidentiality of company documents and personnel records.
Provided exceptional customer service when addressing client inquiries or concerns via phone calls or email correspondence.
Maintained accurate financial records by reconciling accounts payable/receivable transactions regularly to ensure balanced budgets.
Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving.
Maintained vehicle inspections of all vehicles for sale, completed title work
Collected all payments made on car lot in person by customer.
Closed and finalized sales when needed
Medical Assistant/Front Desk Receptionist
Premier Physical Therapy
10.2016 - 04.2017
Sanitized, restocked, and organized exam rooms and medical equipment.
Obtained client medical history, medication information, symptoms, and allergies.
Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
Performed medical records management, including filing, organizing and scanning documents.
Handled on incoming phone calls
Maintained current insurance verifications
Collected Copayments and created all financial payment plans
Intake Coordinator/Receptionist
Grace Compassion Home Health Care
05.2014 - 06.2015
Provided excellent customer service to patients, family members, and healthcare providers during the intake process.
Maintained strict confidentiality of patient information, adhering to HIPAA guidelines and company policies.
Reduced errors in patient data entry with thorough verification processes and attention to detail.
Completed intake assessment forms and filed clients' charts.
Routed all incoming calls to appropriate department
Assisted with insurance verification, and billing paperwork.
Scheduled recurring patient appointments.
Education
Technical Degree in Medical/Administrative - Medical Assistant
Everest College
Dallas, TX
07-2013
Skills
ICD-10 proficiency
Appeals handling
HIPAA compliance
Patient confidentiality
Insurance verification
Claims processing
Denial management
Medical billing
Medicare regulations
Medicaid guidelines
Customer service
Medical record review
Medical terminology
Critical Decision-making
Knowledgeable in EPIC
Provider relations
HMO insurance policies
Electronic health records (EHR)
Data entry
Time management abilities
Insurance coverage verification
Certification
Medical Assistant
BLS
Timeline
Medical Insurance Specialist
Baylor Scott & White
06.2021 - 09.2023
Workers Compensation Coordinator
Madsen Orthopedics
11.2019 - 05.2020
Intake Coordinator
Bone and Joint Orthopedics
08.2019 - 01.2020
Office Manager
America's Car-Mart
01.2018 - 01.2019
Medical Assistant/Front Desk Receptionist
Premier Physical Therapy
10.2016 - 04.2017
Intake Coordinator/Receptionist
Grace Compassion Home Health Care
05.2014 - 06.2015
Medical Assistant
BLS
Technical Degree in Medical/Administrative - Medical Assistant
Everest College
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