Veronica Gore
Conway,South Carolina
Summary
Highly motivated individual experienced in the insurance industry, specializing in claims. Proven track record of success in resolving challenging cases and ensuring customer satisfaction. Possesses strong communication skills by effectively interacting and establishing relationships with customers. Excellent organizational and management skills with the ability to manage a high volume of claims.
Overview
21
21
years of professional experience
Work History
CLAIMS SPECIALIST
HCA
Myrtle Beach
01.2022 - 02.2025
- Create billing and accounting reports
- Prepare claims
- Maintain databases and other company records
- Perform data input
- Provided customer service to policyholders and claimants by answering their questions, resolving disputes, and explaining coverage details
- Reviewed incoming documentation for completeness prior to processing a claim.
MEDICAL RECORDS CLERK
BCBS
Myrtle Beach, SC
08.2009 - 06.2021
- Maintained up-to-date knowledge of HIPAA regulations related to the protection of PHI
- Scanned documents into electronic health record system utilizing scanning software
- Organized release of medical information to authorized personnel
- Provided customer service to patients by answering questions regarding their records
- Scanned paper medical records for electronic filing
- Demonstrated expertise in organizing, filing, and retrieving patient records accurately and efficiently
- Uploaded physician progress notes, history and physicals into electronic medical records
FRONT DESK RECEPTIONIST
Conway Obstetrics & Gynecology
Conway
03.2006 - 02.2007
- Professionally assist doctors, staff, visitors and patients
- Maintain business inventory such as checking supplies, scheduling equipment and maintenance repairs
- Answer all phone calls in a professional and courteous manner
- Perform all duties within HIPAA regulations
- Maintain confidentiality of all doctor, staff and patient information
- Schedule appointments between doctors and patients
- Liaise between medical departments with discretion and professionalism
- Adhere to policy.
CLAIMS PROCESSOR
First Source
Conway
03.2004 - 12.2004
- Research and process claims according the processing guidelines and benefits
- Contact and follow up with members for additional correspondence
- Responsible for accurate and timely daily reports
- Verified insurance coverage by reviewing policies, endorsements, and other documents.
Education
ASSOCIATE IN SCIENCE (A.S.) - HEALTH ADMINISTRATION
Ultimate Medical Academy
Clearwater04.2019
Skills
- Insurance coverage verification
- Claims adjustment
- Documentation skills
- Information verification
- Data entry
- Appointment scheduling
- Documentation processing
Timeline
CLAIMS SPECIALIST
HCA
01.2022 - 02.2025
MEDICAL RECORDS CLERK
BCBS
08.2009 - 06.2021
FRONT DESK RECEPTIONIST
Conway Obstetrics & Gynecology
03.2006 - 02.2007
CLAIMS PROCESSOR
First Source
03.2004 - 12.2004
ASSOCIATE IN SCIENCE (A.S.) - HEALTH ADMINISTRATION
Ultimate Medical Academy