Summary
Overview
Work History
Education
Skills
Timeline
Generic

John C. Murray

Orlando,FL

Summary

Insurance professional with strong background in verifying insurance coverage and benefits. Skilled in navigating complex systems, resolving discrepancies, and ensuring accurate information. Known for excellent team collaboration and adaptability to changing needs. Efficient in communication, problem-solving, and maintaining high standards for quality and results.

Overview

10
10
years of professional experience

Work History

Insurance Verification Specialist, Level 4

Alliance Rx, Walgreens
09.2019 - 07.2024
  • Oversaw enforcement of all integrity procedures and policies to resolve claims
  • Monitored and updated all data transition and transmission processes
  • Responsible for verifying patient insurance billing, claims processing, and prior authorizations
  • Maintained and conducted research in payer database

Insurance Benefits Investigator

CENTENE, Health Specialty
09.2015 - 06.2018
  • Obtain and verify insurance eligibility for services provided
  • Perform prior authorizations required by payor source
  • Document pertinent communication with clients and stakeholders in customer management database
  • Determine client’s financial responsibilities and bill insurance companies for appropriate therapies

Claims Benefit Specialist

INNOSOURCE, Aetna
09.2014 - 07.2015
  • Reviewed eligibility and investigated benefits in accordance with medical claims processing guidelines
  • Researched and analyzed claim denials
  • Worked with operational departments to research and resolve mail order and claims issues

Education

Tallahassee Community College
Tallahassee, FL

Skills

  • MS Office applications
  • Excel
  • Access
  • Word
  • Drafting
  • Submitting complex insurance correspondence
  • Communication skills
  • Interpersonal skills

Timeline

Insurance Verification Specialist, Level 4

Alliance Rx, Walgreens
09.2019 - 07.2024

Insurance Benefits Investigator

CENTENE, Health Specialty
09.2015 - 06.2018

Claims Benefit Specialist

INNOSOURCE, Aetna
09.2014 - 07.2015

Tallahassee Community College
John C. Murray