CYNTHIA HOSKINS CHARLES
PORTER,TX
Summary
Detail-oriented Insurance Verification Specialist with over 17 years of experience in eligibility verification, claims processing, and patient communication. Skilled in navigating complex insurance processes while maintaining accurate documentation. Skilled Insurance Verification Specialist with experience in verifying insurance coverage, understanding policies, and processing claims. Strengths include strong analytical skills, attention to detail, and ability to work under pressure. Proven record of improving efficiency in handling claims and enhancing customer satisfaction through timely resolution of disputes and issues.
Overview
18
18
years of professional experience
Work History
Insurance Verification Specialist
St. Joseph's Hospital and Medical Center
Houston, Texas
09.2008 - Current
- Verified patient insurance eligibility for various medical services and procedures.
- Communicated with insurance companies to resolve coverage inquiries and discrepancies.
- Maintained accurate patient insurance records in electronic systems to ensure compliance and accessibility.
- Collaborated with healthcare providers to obtain necessary documentation for claims processing.
- Educated patients about their insurance benefits and financial responsibilities.
- Reviewed and updated insurance verification policies, streamlining processes to improve workflow efficiency.
- Assisted in training new staff on insurance verification processes and systems.
- Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
- Maintained accurate documentation on all pre-authorization requests, denials and appeals.
- Navigated through multiple online systems to obtain documentation.
- Updated patient and insurance data and input changes into company computer system.
- Developed knowledge of insurance plans, including Medicare and Medicaid regulations, to enhance verification accuracy.
- Contacted patients to confirm demographic information and communicate financial responsibilities.
- Reviewed medical records to ensure accuracy of required information needed for pre-authorization requests.
- Retained strong medical terminology understanding in effort to better comprehend procedures.
- Responded promptly to customer inquiries regarding their benefits and eligibility status.
- Instructed clients on amounts covered under benefits plans in easy-to-understand terminology.
- Maintained confidentiality of patient information in accordance with HIPAA regulations.
- Developed and maintained professional relationships with insurance representatives.
- Collaborated with healthcare providers to communicate insurance coverage and authorization details.
- Answered telephones and directed calls to appropriate medical or adminstrative staff.
- Communicated with patients with compassion while keeping medical information private.
Education
High School Diploma -
GEORGE WASHINGTON HIGH SCHOOL
San Francisco, CASkills
- Insurance eligibility verification
- Claims processing
- Electronic health records
- HCFA documentation
- Pre-authorization coordination
- Medical terminology comprehension
Timeline
Insurance Verification Specialist
St. Joseph's Hospital and Medical Center
09.2008 - Current
High School Diploma -
GEORGE WASHINGTON HIGH SCHOOL