Melissa Grobeck
Omaha,NE
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
13
13
years of professional experience
Work History
Insurance Verification Specialist/Surgery Scheduler
Advanced Surgery Center
11.2020 - Current
- Ensured compliance with HIPAA regulations while managing sensitive patient information during the verification process.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Updated patient records with accurate, current insurance policy information.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Improved communication between medical staff and patients by explaining insurance benefits and financial responsibilities.
- Collaborated with team members to resolve discrepancies in insurance verification, ensuring proper billing practices.
Insurance Coordinator
Physicians Choice NE LLC
10.2018 - 09.2020
- Scan in authorization approval letters from insurance companies and uploaded them.
- Verify all patients insurance is active at the first of every month, and that they haven't changed insurance companies.
- Check Medicare to verify it's active and primary.
- Validate insurance and advised patients of benefits and coverage.
- Secure pre-authorizations and pre-certifications for minor surgical procedures performed in home settings.
- Verify policy holder data, including age, contact number and physical address.
- Comply with confidentiality regulations in handling customer information.
- Created master spreadsheet to record procedures, denials and approvals.
- Verified insurance and communicated coverage to staff and patients.
- Managed a high volume of inbound calls, promptly resolving issues while providing accurate information on policies and procedures.
- 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.
- Verified client information by analyzing existing evidence on file.
- Posted payments to accounts and maintained records.
- Enhanced claim processing efficiency by verifying insurance coverage and benefits for patients.
- Reduced discrepancies in billing by consistently obtaining accurate patient information and documentation.
Customer Care Coordinator
Life Line Screening
05.2016 - 09.2018
- Keep customer and system account information accurate and current to support timely resolutions for all concerns.
- Provide high level of quality control, eliminating downtime to maximize revenue.
- De-escalate customer issues with proven conflict mediation and problem-solving abilities.
- Reconcile accounts, posted daily entries and conducted financial analysis with the Life Line Screening Software.
- Deliver fast, friendly and knowledgeable service for routine questions and service complaints.
- Maximize revenue by proactively building and managing key customer relationships.
Day Habilitation Assistant
Developmental Services of Nebraska
12.2015 - 03.2016
- Record consumer's interactions,complaints and progress daily.
- Verify that appropriate goals were run for each consumer on a daily basis allowing the ability to bill for their time at Day services.
- Maintain household office and operations manuals to define staff expectations, confidentiality requirements and household and office procedures.
- Report concerns to supervisory Day Time Coordinator to maintain optimal care for all client needs.
Customer Service
Saratoga Bridges NYSARC
05.2012 - 12.2015
- Provided company information and policies to customers upon inquiry and answered questions via phone, email, or online chat.
- Maintained detailed records of client interactions, ensuring accurate documentation for future reference.
- Described product and service details to customers to provide information on benefits and advantages.
- Explained online self-help options to customers to promote additional and after-hours support choices.
- Developed working relationships with internal and external customers while assisting with account management duties.
Education
Associate of Science - Medical Office And Billing
Ultimate Medical Academy - Clearwater
Clearwater, FLSkills
- Microsoft Word, and Outlook
- Electronic Medical Records,HST, Waystar
- Insurance Verification, Customer Service
- HIPAA Compliance, Documentation
- Attention to detail
- Strategic thinking skills
- CPT Codes,
- Decision-making, Multitasking
- Organization
- Team building
- Communications
- Patient confidentiality
- Attention to Detail
- Insurance Coverage Verification
- Eligibility Determination
Timeline
Insurance Verification Specialist/Surgery Scheduler
Advanced Surgery Center
11.2020 - Current
Insurance Coordinator
Physicians Choice NE LLC
10.2018 - 09.2020
Customer Care Coordinator
Life Line Screening
05.2016 - 09.2018
Day Habilitation Assistant
Developmental Services of Nebraska
12.2015 - 03.2016
Customer Service
Saratoga Bridges NYSARC
05.2012 - 12.2015
Associate of Science - Medical Office And Billing
Ultimate Medical Academy - Clearwater
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