Nora Hernandez
Mercedes
Summary
Friendly Insurance Verifier with many years of experience as a professional. Looking to tackle new responsibilities in the medical insurance verification industry. Skilled at reviewing, analyzing, and interpreting various insurance policies.
Overview
21
21
years of professional experience
Work History
Insurance Verifier
Doctors Hospital at Renaissance Health System
Weslaco
04.2004 - Current
- Evaluated medical necessity of services provided by providers.
- Verified insurance coverage and eligibility for services using computer software.
- Analyzed reports generated from automated systems for errors or inconsistencies.
- Submitted prior authorization requests to insurance companies when necessary.
- Ensured compliance with HIPAA regulations when handling confidential patient information.
- Reviewed patient information to ensure accuracy of data entered into the system.
- Assisted in training new staff on insurance verification processes and procedures.
- Maintained accurate records of all transactions involving insurance verifications.
- Instructed clients on amounts covered under benefits plans in easy-to-understand terminology.
- 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.
- Navigated through multiple online systems to obtain documentation.
- Updated patient accounts with insurance verification information to ensure accurate billing.
- Contacted patients to arrange payment arrangements for deductible and out-of-pocket liability.
- Managed multiple tasks and priorities in a high-volume, fast-paced environment.
- Scheduled and confirmed patient appointments and consultations.
- Greeted patients, determined purpose of visit and directed to appropriate staff.
- Scheduled tests, lab work or x-rays for patients based on physician orders.
- Managed front office customer service, appointment management, billing and administration tasks to streamline workflow.
- Answered telephones and directed calls to appropriate medical or adminstrative staff.
Education
GED -
Mercedes High Schools
05-1983
Skills
- Insurance verification
- HIPAA compliance
- Prior authorization
- Customer service
- Team collaboration
- Problem solving
- Training and mentoring
- Healthcare regulations
- Policy interpretation
- Customer service experience
- Strong MS office abilities
- Communication and interpersonal skills
- Insurance coverage verification
- Accuracy and precision
- Prior authorization processing
- Data entry and review
- Data verification
- Patient contact
- Private insurance
- Coordination and scheduling
- Insurance benefits verification
- Deductible & co-pay calculation
- Medicaid
- Customer relationship management
- Patient confidentiality
- Patient rapport
References
References available upon request.
Timeline
Insurance Verifier
Doctors Hospital at Renaissance Health System
04.2004 - Current
GED -
Mercedes High Schools
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