Stephanie Jones
Bedford,TX
Summary
Insurance Verification Specialist 18 years of expertise in benefits explanation and coverage tracking, building patient rapport and preserving data integrity. Reliable and possessing extensive commercial and government benefits knowledge. A team player with a vast knowledge of medical terms and working with all types of personalities effectively. Offering dynamic organizational skills and attention to detail.
Assistant Office Manager successful at delivering vital clerical support to internal teams and customers.
Overview
18
18
years of professional experience
Work History
Insurance Verification Specialist
Castle Therapy Partners
Southlake, TX
07.2020 - Current
- Observed strict procedures to protect sensitive patient information, medical records and payment data.
- Posted payments to accounts and maintained records.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Communicated verification and authorization status updates with front office/scheduling department and director of the clinics to facilitate decision-making for patient admissions and insurance coverage.
- Verified client information by analyzing existing evidence on file.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Reviewed patient cases and verified insurance coverage information.
- Scheduled patient appointments in respective appointment times and followed up with reminder phone calls.
- Kept detailed records of office inventories and placed orders for more supplies.
- Managed office logistics by scheduling appointments, maintaining files and collecting payments.
- Organized and maintained patient chart filing system to promote quick data finding for staff.
- Greeted visitors and initiated appointment processes for clients to streamline patient flow.
- Placed new supply orders, managed inventory and restocked clerical spaces.
- Obtained payments from patients and scanned identification and insurance cards.
Insurance Verification Specialist
Touchstone Imaging
Arlington, TX
12.2018 - 07.2020
- Observed strict procedures to protect sensitive patient information, medical records and payment data.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Communicated verification and authorization status updates with front office department to facilitate decision-making for patient admissions and insurance coverage.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Reviewed patient cases and verified insurance coverage information.
Insurance Verification Specialist
Crown Imaging
Dallas, TX
05.2018 - 12.2018
- Determined appropriateness of payers to protect organization and minimize risk.
- Observed strict procedures to protect sensitive patient information, medical records and payment data.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Communicated verification and authorization status updates with front office department to facilitate decision-making for patient admissions and insurance coverage.
- Verified client information by analyzing existing evidence on file.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Reviewed patient cases and verified insurance coverage information.
Insurance Verification Specialist
Baylor Scott & White Texas Spine & Joint Hospital
Tyler, TX
10.2012 - 05.2018
- Observed strict procedures to protect sensitive patient information, medical records and payment data.
- Determined appropriateness of payers to protect organization and minimize risk.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Communicated verification and authorization status updates with scheduling and admitting department to facilitate decision-making for patient admissions and insurance coverage.
- Verified client information by analyzing existing evidence on file.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Reviewed patient cases and verified insurance coverage information.
Insurance Authorization Specialist
Centre Of Rehabilitation Excellence
Longview, TX
09.2004 - 02.2012
- Input all patient data regarding claims and prior authorizations into system accurately.
- Reached out to worker’s compensation insurance carriers adjuster’s to obtain prior authorization for outpatient physical therapy.
- Researched denied claims and contacted worker’s compensation insurance adjuster’s to resolve these issues.
- Obtained and logged accurate patient worker’s compensation insurance and demographic information for use by worker’s compensation insurance providers and medical personnel.
- Reviewed worker’s compensation insurance coverage for patients to determine which party was liable for payment.
- Fielded telephone inquiries on authorization details from plan members and medical staff.
- Tracked referral submission during facilitation of prior authorization issuance.
- Authorized outpatient physical therapy and functional capacity testing requests in accordance with applicable plan guidelines.
- Verified eligibility and compliance with authorization requirements for service providers.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Communicated verification and authorization status updates with scheduling department and physical therapist to facilitate decision-making for patient admissions and insurance coverage.
- Maintained confidentiality of patient records and health statuses.
- Made contact with worker’s compensation insurance carriers, adjusters and nurse case managers to discuss policies and individual patient benefits.
- Carried out administrative tasks by communicating with clients and scanning documents.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Determined appropriateness of payers to protect organization and minimize risk.
- Verified client information by analyzing existing evidence on file.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
Education
High School Diploma -
Whitehouse High School
Whitehouse, TXAssociate Of Applied Arts -
Kilgore College
Kilgore, TXSkills
- Office Management
- Office Supplies and Inventory
- Policy and Procedure Modification
- Inquiry Requests
- Employee Paperwork
- Operational Requirements
- Employee Performance Evaluations
- Schedule Preparation
- Restocking Supplies
- Setting Up Appointments
- Deductible Collection
- Correspondence Writing
- Supply Requisition
- Meeting Coordination and Support
- Delegation and Work Assignment
- Error Resolution
- Friendly and Relatable
- Adaptable and Resilient
- HIPAA Regulations
- Electronic Communication Management
- Mail and Package Distribution
- Office Equipment Management
- Payroll Administration
- Safe Work Practices
- Confidence and Drive
- Documentation
- Clerical Support
- Insurance Plan Verification
- Prior Authorization Processing
- Data Entry and Review
- Medical Terminology
- Customer Relationship Management
- Advising Patents
- Organization and Time Management
- Insurance Terminology
- Electronic Authorization Processing
- Patient Rapport
- Coordination and Scheduling
- Customer Service
- Attention to Detail
- Communication and Interpersonal Skills
- Documentation and Correspondence
- Medicare Knowledge
- Electronic Medical Record
- Coverage and Authorizations
- CPT Coding
- Patient Health Information Access
- Payment Plan Options
- Referral Verification
- Radiology Knowledge
- Payment Scheduling and Collection
- Calendar and Appointment Management
- Patient Eligibility Requirements
- Documentation Review
- Order Purchasing
- Insurance Authorizations
- Teamwork and Collaboration
- Computer Proficiency
- Office Coordination
- Patient Database Maintenance
- Adaptable and Flexible
- Insurance coverage verification
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
Life is a learning process
My Dad
Timeline
Insurance Verification Specialist
Castle Therapy Partners
07.2020 - Current
Insurance Verification Specialist
Touchstone Imaging
12.2018 - 07.2020
Insurance Verification Specialist
Crown Imaging
05.2018 - 12.2018
Insurance Verification Specialist
Baylor Scott & White Texas Spine & Joint Hospital
10.2012 - 05.2018
Insurance Authorization Specialist
Centre Of Rehabilitation Excellence
09.2004 - 02.2012
High School Diploma -
Whitehouse High School
Associate Of Applied Arts -
Kilgore College
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