Carmen Acosta
Staten Island,NY
Summary
Authorized to work in the US for any employer Pragmatic Insurance Verification Specialist touting eight 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.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Verification Specialist
Kindbody
03.2023 - Current
- Verified client information by analyzing existing evidence on file.
- Determined appropriateness of payers to protect organization and minimize risk.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Updated patient records with accurate, current insurance policy information.
- Established and maintained relationships with insurance providers for productive communications.
- Communicated verification and authorization status updates with departments to facilitate decision-making for patient admissions and insurance coverage.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Assisted patients with understanding personalized insurance coverage and benefits.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Managed over 10 infertility verifications per day
- Generated reports to track insurance verifications.
Verification Specialist Team Lead
H&D Physical Therapy
10.2018 - 08.2021
- Established and maintained relationships with insurance providers for productive communications.
- Communicated verification and authorization status updates with billing department to facilitate decision-making for patient admissions and insurance coverage.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Achieved insurance pre-authorizations to enable timely patient procedures.
- Negotiate Out of-Network rates
- Reverify all coverages for new calendar year
- Generated reports to track insurance verifications and claim progress.
- Serving as guidance to departments during difficult decisions
- Verified client information by analyzing existing evidence on file.
- Determined appropriateness of payers to protect organization and minimize risk.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Updated patient records with accurate, current insurance policy information.
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
- Trained new team members by relaying information on company procedures and safety requirements.
- Coached team members in techniques necessary to complete job tasks.
- Managed over 50 verifications per day
- Conducted interviews with participants to assess eligibility
- Developed thorough understanding of job requirements and qualifications to steer recruitment efforts toward appropriate job profiles
Verifications Specialist
Motion Physical Therapy
03.2015 - 08.2018
- Proficient in collecting authorizations from EPACES and obtaining retroactive visits, and prior authorizations
- Familiar with all major insurance companies while obtaining proper benefits and responsibilities for patients
- Front Desk duties when required, collecting all documents, checking in patients, scheduling appointments
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Verified client information by analyzing existing evidence on file.
- Determined appropriateness of payers to protect organization and minimize risk.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Updated patient records with accurate, current insurance policy information.
- Established and maintained relationships with insurance providers for productive communications.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Worked effectively in fast-paced environments.
- Worked well in a team setting, providing support and guidance.
College Assistant
Borough of Manhattan Community College
08.2012 - 03.2015
- Service over 100 students for admission into college and helped with applications
- Greet students when registration begins, obtain all proper documents
- Transferred credits for all majors to CUNY website, helped transfer students with application process
- Front Desk duties, directing students to proper offices to complete admission process
- Filing all students' records and personal information in proper cabinets
- Answered all student questions and phone calls
- Data Entry for admission applications changed majors and removed holds in student CUNY accounts
- Edited and proofread documents for accuracy and completeness
- Supported staff on special assignments and provided extra assistance
- Input data into spreadsheets and databases
- Answered and managed incoming and outgoing calls while recording accurate messages for distribution to office staff
Administrative Assistant/Assistant Manager
Bridge Back, Life Center Inc
10.2007 - 11.2009
- Serve as intake coordinator working closely with various agencies to facilitate referrals
- Proficient in maintaining NYS OASAS applications databanks
- Completed bi-weekly payroll for 10 employees.
- Managed incoming calls; scheduled appointments; and provided customer assistance
- General clerical duties in Medical filing, faxing, and maintaining phone logs
- Assist with mailings, UPS & Postal mail
- Manage purchase of office supplies, ensure office equipment is operational, and coordinate maintenance and service contracts as needed
- Ordered and distributed work orders
- Performed accounting activities by preparing expense reports, purchase orders, and invoices.
- Monitored office supplies to order and replenish stock when necessary.
- Assisted in answering Patient questions and needs
- Coverage for Office Manager when required
- Organized and updated databases, records, and other information resources
- Performed accounting activities by preparing expense reports, purchase orders, and invoices
- Built and managed processes for tracking and monitoring department performance
Education
Bachelor of Science - Criminal Justice, Law in Criminal Justice
John Jay College of Criminal Justice
New York, NY01.2023
Associate of Arts - Criminal Justice
Borough of Manhattan Community College
New York, NY05.2019
Skills
- Written Skills Computer
- Medical Terminology
- EMR systems
- Communication skills
- Computer skills
- Microsoft Office
- Negotiation
- Insurance Terminology
- Customer Care
- HIPAA
- Word processing
- Intake
- Patient monitoring
- Fluent in Spanish
- Bilingual
Additional Information
- Dean's List August 2022
Certification
- Lawyering for Social Justice, Proskauer Rose LLP - May 2023
Languages
Spanish
Native or Bilingual
Timeline
Verification Specialist
Kindbody
03.2023 - Current
Verification Specialist Team Lead
H&D Physical Therapy
10.2018 - 08.2021
Verifications Specialist
Motion Physical Therapy
03.2015 - 08.2018
College Assistant
Borough of Manhattan Community College
08.2012 - 03.2015
Administrative Assistant/Assistant Manager
Bridge Back, Life Center Inc
10.2007 - 11.2009
Bachelor of Science - Criminal Justice, Law in Criminal Justice
John Jay College of Criminal Justice
Associate of Arts - Criminal Justice
Borough of Manhattan Community College
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