Ruth Kerner-Sims
La Grange,NC
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
2023
2023
years of professional experience
Work History
Insurance Verification Specialist
Mary Immaculate Hospital
Insurance Verification Specialist
Sentara Healthcare
06.2005 - 09.2022
- Verified patient insurance eligibility and benefits information to ensure accurate billing processes.
- Communicated with insurance providers to resolve discrepancies and facilitate timely authorizations.
- Reviewed and updated patient records in electronic health systems for compliance with regulations.
- Collaborated with medical staff to gather necessary documentation for insurance claims processing.
- Assisted patients in understanding their coverage options and resolving billing inquiries effectively.
- Monitored changes in insurance policies to maintain up-to-date knowledge of coverage requirements.
- Trained new team members on verification procedures and best practices for accuracy and efficiency.
- Optimized workflow processes to increase efficiency, resulting in decreased verification turnaround times.
- 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.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Collaborated with team members to resolve discrepancies in insurance verification, ensuring proper billing practices.
- Increased patient satisfaction by promptly addressing concerns regarding insurance coverage or billing issues.
- Enhanced claim processing efficiency by verifying insurance coverage and obtaining pre-authorizations for procedures.
Until Secretary
UNC Wayne Memorial Hospital
2021 - 2022
- Managed scheduling and appointment coordination for healthcare professionals.
- Processed patient records and maintained confidentiality in compliance with HIPAA regulations.
- Assisted in the preparation of medical documentation and reports for clinical staff.
- Facilitated communication between departments to enhance operational efficiency.
Education
High School Diploma - General Studies
Floyd E Kellam High School
Virginia Beach, VA06.1975
Timeline
Insurance Verification Specialist
Sentara Healthcare
06.2005 - 09.2022
Insurance Verification Specialist
Mary Immaculate Hospital
Until Secretary
UNC Wayne Memorial Hospital
2021 - 2022
High School Diploma - General Studies
Floyd E Kellam High School