Accomplished Insurance Coordinator with a proven track record at Stanford
children's Hospital, adept in CPT coding and enhancing customer satisfaction. Demonstrated expertise in streamlining insurance processes and fostering patient rapport, significantly improving operational efficiency. Passionate about leveraging attention to detail and regulatory compliance to achieve optimal outcomes.
Pragmatic Insurance Verification Specialist touting 28 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
32
32
years of professional experience
Work History
Insurance Coordinator
Stanford Children's Hospital
07.2009 - 08.2022
Verified insurance and communicated coverage to staff and patients.
Assisted clients with understanding complex insurance policies, effectively addressing concerns or questions.
Obtained data such as patient, insurance ID, insurance provider and medical codes to properly file insurance claims.
Made contact with insurance carriers to discuss policies and individual patient benefits.
Managed a high volume of inbound calls, promptly resolving issues while providing accurate information on policies and procedures.
responsible for single case agreements and all documentation needed for authorizations.
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Obtained prior authorization and precertification for outpatient procedures.
Filed and tracked insurance claims and communicated claims status to patients.
Maintained confidentiality of patient finances, records, and health statuses.
Communicated effectively with staff members of operations, finance and clinical departments.
Assured timely verification of insurance benefits prior to patient procedures or appointments.
Checked documentation for accuracy and validity on updated systems.
Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
Modified, updated and processed existing policies.
Enhanced customer satisfaction by efficiently handling insurance claims and processing policy updates.
Reviewed outstanding requests and redirected workloads to complete projects on time.
Contributed positively to team morale by consistently demonstrating a collaborative attitude and willingness to support colleagues.
Analyzed data from various sources to identify patterns in claims activity, allowing for more effective prevention strategies moving forward.
Coordinated with contracting department to resolve payer issues.
Maintained strong knowledge of basic medical terminology to better understand services and procedures.
Notified insurance agents and accounting departments of policy cancellations and changes.
Implemented customer feedback mechanisms to identify areas of improvement in service delivery.
Increased team efficiency with development of comprehensive training materials on insurance protocols.
Assisted in resolving complex insurance claims, liaising between clients and providers for favorable outcomes.
Facilitated smoother internal communication, organizing regular meetings between different departments.
Facilitated knowledge-sharing sessions on emerging insurance trends, keeping team informed and proactive.
Maintained up-to-date knowledge of insurance regulations, ensuring company compliance with current laws.
Worked well in a team setting, providing support and guidance.
Excellent communication skills, both verbal and written.
Proven ability to learn quickly and adapt to new situations.
Skilled at working independently and collaboratively in a team environment.
Self-motivated, with a strong sense of personal responsibility.
Demonstrated respect, friendliness and willingness to help wherever needed.
Assisted with day-to-day operations, working efficiently and productively with all team members.
Paid attention to detail while completing assignments.
Used critical thinking to break down problems, evaluate solutions and make decisions.
Adaptable and proficient in learning new concepts quickly and efficiently.
Proved successful working within tight deadlines and a fast-paced environment.
New Patient Coordinator
Stanford Children's Hospital
01.2001 - 06.2006
Managed a high volume of inbound calls while maintaining accuracy in appointment scheduling and patient record updates.
Provided backup to front desk to step in to assist with various tasks whenever employee was absent or at lunch.
Managed sensitive patient information with strict adherence to HIPAA guidelines, maintaining confidentiality and privacy at all times.
Provided exceptional customer service by addressing concerns, answering questions, and ensuring patient satisfaction with their care experience at the clinic.
Streamlined communication between patients and healthcare providers, ensuring timely responses to inquiries and concerns.
Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
Trained new staff members on office procedures and protocols, ensuring consistency in patient care delivery.
Resolved issues through active listening and open-ended questioning, escalating major problems to manager.
Increased office efficiency by creating clear communication channels between staff, patients, and healthcare providers.
Collaborated with medical staff to develop streamlined processes for managing referrals from other healthcare providers.
Facilitated seamless transitions for new patients by gathering necessary documentation and insurance information prior to appointments.
Provided exceptional customer service, addressing concerns and answering inquiries promptly and professionally.
Worked well in a team setting, providing support and guidance.
Assisted with day-to-day operations, working efficiently and productively with all team members.
Proved successful working within tight deadlines and a fast-paced environment.
Developed and maintained courteous and effective working relationships.
Demonstrated strong organizational and time management skills while managing multiple projects.
Resolved patient concerns and complaints with empathy and professionalism, restoring trust in healthcare services.
Ins Coding and Billing
Stanford Medical Center
04.1990 - 12.2000
Implemented new ICD-10 codes efficiently upon release, minimizing disruptions in claims processing while maintaining accuracy levels.
Conducted audits of coding practices within the department, identifying areas for improvement and implementing corrective action plans.
Collaborated with healthcare providers to clarify documentation discrepancies, resulting in more accurate claim submissions.
Supported departmental goals by collaborating with cross-functional teams to resolve complex billing issues and streamline operational processes.
Reduced claim denials with thorough verification of insurance coverage and patient eligibility before submitting claims.
Safeguarded patient confidentiality by adhering to strict HIPAA guidelines when handling sensitive information during the billing process.
Improved coding accuracy by consistently reviewing and updating medical records, ensuring compliance with industry standards.
Maintained a high level of expertise through ongoing professional development, attending workshops and conferences focused on industry updates and best practices.
Used data entry skills to accurately document and input statements.
Worked effectively in fast-paced environments.
Proven ability to learn quickly and adapt to new situations.
Worked well in a team setting, providing support and guidance.
Demonstrated respect, friendliness and willingness to help wherever needed.
Passionate about learning and committed to continual improvement.
Managed time efficiently in order to complete all tasks within deadlines.
Paid attention to detail while completing assignments.
Developed and maintained courteous and effective working relationships.
Demonstrated strong organizational and time management skills while managing multiple projects.