Valerie De Wijk
Seminole,FL
Summary
Insurance Verification Specialist with expertise in maintaining patient confidentiality and in-depth knowledge of Medicaid and private policy benefits. Skilled in building relationships and communicating effectively. Seeking a challenging opportunity with a company that values dynamic skills and a strong work ethic.
Overview
13
13
years of professional experience
Work History
Benefit Verification Specialist I
Organogenesis
St. Petersburg, FL
07.2021 - Current
- Reviewed and verified health insurance benefits for patients prior to completing received orders from providers.
- Identified discrepancies in patient benefit information and resolved them with the insurance provider.
- Worked with healthcare professionals to verify precision of patient documentation and validate service qualifications.
- Analyzed intricate insurance policy language to ascertain coverage for benefits.
- Maintained accurate records of all verifications, including date of service, procedure codes, diagnosis codes.
- Resolved provider inquiries regarding benefit eligibility in a timely manner.
- Entered benefit verification data into relevant systems.
- Accurately inputted orders into computer system.
- Verified customer information, including shipping address.
- Managed fax queue to process orders and ensured accuracy of order details including frequency, provider information, and missing days.
Audit Analyst
Lincare
Clearwater, FL
04.2012 - 10.2019
- Retrieve medical records for appeal processes
- Coordinated document readiness for Medicare evaluation processes
- Maintained communication with Medicare practices when necessary.
- Processed, analyzed, and responded to Medicare claim audits throughout formal appeal stages
- Created spreadsheets for compiling work
- Maintained record of submitted work via AS400 system
Education
High School Diploma -
Ozark High School
Ozark, AR05-1982
Medical Billing - Medical Billing
Ashworth College
Norcross, GASkills
- Team Management
- Conflict Resolution
- Decision-Making
- Training & Development
- Customer Relations
- Clerical Support
- Planning
- Networking
- Basic Math
- MS Office
- Healthcare regulations
- Insurance knowledge
- Policy Interpretation
- Accuracy and Precision
- Benefits Explanation
- Proficient in AS400
- Relationship Building
Timeline
Benefit Verification Specialist I
Organogenesis
07.2021 - Current
Audit Analyst
Lincare
04.2012 - 10.2019
High School Diploma -
Ozark High School
Medical Billing - Medical Billing
Ashworth College
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