Susana Alfaro
Wellington ,FL
Summary
Results-driven Insurance Verification Specialist known for expertise in data entry and medical billing. Successfully navigated complex insurance systems to verify coverage and ensure accurate documentation, ready to leverage skills to enhance patient satisfaction and operational effectiveness.
Overview
19
19
years of professional experience
Work History
Insurance Verification Specialist
Wellington Regional Medical Center
Wellington , FL
01.2012 - Current
- Communicated with insurance providers to clarify coverage details and requirements.
- Processed pre-authorization requests to ensure compliance with insurance policies.
- Communicated with insurance carrier, patient and third party or employer to verify patient insurance benefits.
- Updated patient and insurance data and input changes into company computer system.
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
- Analyzed Explanation of Benefits statements from various insurers and shared pertinent information with other departments.
- Navigated through multiple online systems to obtain documentation.
- Evaluated policies and procedures related to Insurance Verification activities.
- Participated in training sessions on new software programs used for verification purposes.
- Assisted in training new staff on insurance verification protocols and procedures.
Surgical Center Insurance Verification
Wellington Regional Medical Center
Wellington Regional Medical Center , FL
01.2010 - 01.2012
- Verified insurance eligibility for various medical procedures and services.
- Informed patients about coverage details and pre-authorization requirements to ensure understanding and compliance.
- Contacted patients to confirm demographic information and communicate financial responsibilities.
- Handled incoming calls from patients and providers about insurance issues, resolving concerns and providing clarity.
- Verified insurance coverage and eligibility for services using computer software.
- Submitted prior authorization requests to insurance companies, facilitating timely approvals for patient care.
- Updated patient and insurance data and input changes into company computer system.
- Reviewed patient information to ensure accuracy of data entered into the system.
Financial Counselor
Wellington Regional Medical Center
Wellington , FL
12.2007 - 01.2010
- Provided financial counseling to patients regarding medical costs and payment options.
- Educated patients on insurance benefits and coverage limitations for medical services.
- Developed patient budgets to help manage healthcare expenses effectively.
- Coordinated with social services to connect patients with additional resources and support.
- Assisted patients in completing financial assistance applications and verifying eligibility.
Medical Insurance Collector
Wellington Regional Medical Center
Wellington Regional Medical Center , FL
11.2006 - 08.2007
- Managed patient accounts to secure timely collection of outstanding balances, reducing delays in cash flow.
- Collaborated with healthcare providers to resolve billing discrepancies, enhancing accuracy and improving patient satisfaction.
- Utilized electronic health record systems to track collections and payments efficiently.
- Resolved discrepancies with insurance companies regarding claim payments.
- Investigated denied claims to determine cause of denial and appeal as necessary.
- Prepared monthly reports detailing collection activity, providing actionable insights for management decisions.
Education
High School Diploma -
John I. Leonard High School
Greenacres City, FL06-1990
Some College (No Degree) - Business Administration And Management
Palm Beach State College
Lake Worth, FLSkills
- Insurance verification
- Claims management
- Medical billing
- Pre-authorization processing
- Regulatory compliance
- Data entry
- Patient communication
- Attention to detail
- Time management
- Problem solving
- Staff training
Timeline
Insurance Verification Specialist
Wellington Regional Medical Center
01.2012 - Current
Surgical Center Insurance Verification
Wellington Regional Medical Center
01.2010 - 01.2012
Financial Counselor
Wellington Regional Medical Center
12.2007 - 01.2010
Medical Insurance Collector
Wellington Regional Medical Center
11.2006 - 08.2007
High School Diploma -
John I. Leonard High School
Some College (No Degree) - Business Administration And Management
Palm Beach State College