Working for the insurance companies, and Insurance Authorization Specialist undertakes the crucial job of processing insurance claims and checking insurance information. A Well-Drafted Insurance Authorization Specialist Resume mentions the following duties – undertaking data entry tasks, approving or denying claims processing, overseeing insurance claims reimbursements, checking insurance information, handling the verification of insurance benefits for customers, notifying customers of deductibles and co-insurance due, exploring other payment options with the customer when needed, and contacting customer when needed.
Eligible candidates for this role normally highlight the following skills on their resumes – insurance claims experience, writing skills, strong communication skills, computer competencies, attention to detail, familiarity with medical terminologies, and professional telephone courtesy. As on-the-job training is provided, education to a degree level is sufficient.
Objective : Detail-oriented Insurance Authorization Specialist with excellent communication skills. Four years of experience working with Primary Care offices, Specialist's office, insurance companies to obtain accurate authorizations or referrals for outpatient and inpatient surgery/admissions. Previous positions to include Medical authorization specialist.
Skills : Very Strong Customer Service , Medical Billing,.
Description :
Responsible for obtaining insurance authorizations for all outpatient services that Bon Secours Health System offers.
Specifically specialized in sleep management services for our Richmond and Hampton Roads-based facilities.
Worked with all major medical plans, including Medicare, Medicaid, and Tricare.
Responsible for verifying current insurance coverage for the patient, verifying patient copays, deductibles, and out of pocket expenses for the service, as well as obtaining the necessary insurance authorization for the service.
Made sure all referral requirements are met.
Assisted with the verification and authorization of MRI's, PET scans, CT scans, x-rays, ultrasounds, pulmonary function testing, echocardiograms, as well as many other services.
Familiared with all state and Federal guidelines regarding Medicare and Medicaid.
Experience
2-5 Years
Level
Junior
Education
Diploma
Insurance Authorization Specialist Resume
Headline : Dependable patient oriented healthcare administrator with background in managing a medical office. Demonstrate a strong background in quality assurance, claims analysis, management principles and practices, EMR system and authorizations for medical insurances. Currently seeking a position with the opportunity for advancement within the healthcare field.
Skills : Insurance Referrals And Authorization, Medical Office.
Description :
Tracked and submited the residential authorizations and updates.
Handled, utilized and abided by the HIPPA compliance on a daily basis.
Coordinated with insurance, our associate directors and direct clinical staff with sending confidential clinical documentation and coordinating utilization reviews.
Tracked insurance, residential reviews and psychiatric authorizations for the youth while they're here, insurance may change multiple times.
Called and checked benefits/eligibility, fill out prior authorizations & set up reviews to determine coverage.
Had the opportunity to prepare the proper credentialing paperwork for our facility & our psychiatrists.
Helped with the reception area when needed, answering phones and directing visitors where they need to go & making them feel comfortable and welcomed.
Experience
5-7 Years
Level
Executive
Education
GED
Insurance Authorization Specialist Resume
Objective : An experienced Insurance Authorization Specialist professional with over 10 years of extensive knowledge and experience in insurance authorizations, referrals, CPT/ICD 10 coding, EMR, and scheduling. Looking for an opportunity to utilize my skills in an environment that will allow growth in this field.
Skills : Customer Service, Computer Skills, Data Entry, CPR.
Description :
Maintained and tracked authorization for 650 clients from all payer sources.
Worked closely with clinicians, referral sources and insurance companies to review if skilled or nonskilled services are appropriate for client.
Validated insurance information and communicate changes or procedures.
Tracked and notified home care staff when insurance requirements or procedures change.
Developed and maintained accurate medical records electronically.
Provided excellent customer service to clinicians, insurance representatives and accounting departments.
Able to understand the medical procedure I am requesting.
Experience
2-5 Years
Level
Executive
Education
MS
Insurance Authorization Specialist Resume
Headline : To obtain a rewarding and challenging Insurance Authorization Specialist position in which I can apply my extensive sales and customer service skills. Well organized, excellent written and verbal communication skills and the ability to adapt well to a fast-paced work environment.
Skills : Microsoft Office, Claimtrak, Office Equipment.
Description :
Verified client insurance eligibility and benefits.
Prepared intake paperwork for following day intake appointments.
Reviewed all next-day appointments for the counseling center.
Attended billing meetings and assist with insurance/billing issues.
Executed any needed reports.
Answered rollover calls for the intake coordinator and schedule intake appointments.
Acted as a backup for the front desk when necessary.
Experience
5-7 Years
Level
Executive
Education
MS
Insurance Authorization Specialist Resume
Headline : Multifaceted and versatile Insurance Authorization Specialist professional with 10 plus years of increasing responsibility in supervision, special education, training, office management, recruiting, and social services. Expert knowledge of office systems and procedures. Strong multi-disciplinary background acquiring advanced skills in all areas of office administration with skills that go beyond a traditional office setting, including outstanding interpersonal skills, advanced conflict resolution, and complex financial negotiation.
Skills : Microsoft Office, Customer Relations, Human Resources Assistance.
Description :
Secured and processed insurance authorization for continued rental or eventual purchase of durable medical equipment used in long-term therapy to increase range of motion in patients with joint contractures.
Completed duties from corporate office and telecommuting from home.
Established contact with, and coordinated between clients, physicians, and insurance companies.
Drafted correspondence.
Tracked regulations on multiple insurance companies cross-country.
Obtained and submitted medical records, prescriptions, and insurance authorization requests.
Verified insurance.
Experience
5-7 Years
Level
Executive
Education
MS
Insurance Authorization Specialist Resume
Objective : Utilizing the phone system application by logging in and setting status of ready, to assist clients/payers/CMs calling into or transferring over on the RCM phone line, Managing incoming phone calls by responding to request and assisting with inquiries and noting the billing system with a summary of the call and actions.
Skills : MS Office, Communication Skills.
Description :
Responsible for verifying and obtaining authorizations as required by insurance companies for new and existing patients via phone and/or online.
Responsible for providing accurate and complete data input for precertification requests and for providing excellent customer service.
Kept authorization spreadsheet up to date and organized for all new and existing patient authorizations.
Monitored emails, voicemails, inbox throughout the day and respond in a timely manner.
Scanned and electronically filing any paperwork in the relevant patient's electronic folder.
Communicated with field nurses and office clinical supervisors.
Get insurance authorizations for home health care from different payors.
Experience
2-5 Years
Level
Executive
Education
MS
Insurance Authorization Specialist Resume
Objective : A self-motivated leader seeking a position where I can utilize my organizational skills and determination to complete assigned tasks in a timely and efficient manner. Experience in the field of healthcare is vast from paramedic to sales, to management. Seeking a life-long career within an established Healthcare company where I will utilize my knowledge and experience to achieve the best results for my company and my patients.
Skills : Windows, Adobe, Outlook, Lynx, E-mail, Messaging, Edge, Internet Explorer, Skype, Access, Calendar, One Drive, Medical Terminology, Fagal, MegaForce, CMS Portal, CPT, And ICD-10 Codes.
Description :
Obtained prior insurance authorization for home care services as referred by the Intake Personnel.
Reviewed requests made by clinicians and other authorized medical staff for additional authorized units.
Worked with Intake Department in releasing the appropriate number of authorized visits to the patient's schedule.
Initiated prior and post-authorization requests via fax transmission and /or telephone contact.
Ensured that all prior authorizations and ongoing authorizations documentation, databases, and records are entered in the database clearly, accurately, and meet HIPPA requirements.
Authorized high-tech radiology tests and procedures for the Aurora Cancer Care. Working very close with several Cancer Care doctors and another specialist for Women's Cancer Care.
Started authorization process for the Cancer Care at the Aurora facility where work.
Experience
0-2 Years
Level
Entry Level
Education
BS In Child Development
Insurance Authorization Specialist Resume
Headline : A highly competent and experienced health administration professional who seeks an opportunity where I may utilize my skills while growing and advancing with the company with which I work. Strong organizational skills, excellent customer service, and office management skills help me to accurately process insurance claims and managing medical information.
Skills : Excel And Powerpoint, Work Well Under Pressure, Bilingual, Multi-Tasker.
Description :
Responsible for getting pre-authorizations/pre-determinations for patients to obtain their HST (home sleep test).
Initiated and obtained these authorizations thru many different systems and companies such as Care Centrix, Evercore, Simply, Ultimate, UMR, etc.
Made sure these are properly initiated approved with the correct procedure codes as well as CPT codes used by the insurance companies.
Responsible for calling the doctor's office to make sure they have properly initiated the pre-authorizations thru the portal, phone, or by fax depending on what insurance company.
Dealt with Humana, Blue Cross Blue Shield in and out of FL, Cigna, Aetna, and Care Plus and I make sure the proper paperwork is faxed to the provider's office or those insurance companies whom we may need to obtain the authorizations from.
Documented eligibility, benefit, and authorization information in accordance with established guidelines.
Initiated all insurance requirements for specific admission type in accordance with established guidelines.
Experience
5-7 Years
Level
Executive
Education
MS
Insurance Authorization Specialist Resume
Headline : Working daily reporting cards listing authorization that is missing, expired, about to expire and any other reporting cards assigned and also Accessing payer portals to collect provided authorization for VRI clients and/or use the portal to request authorizations.
Skills : Microsoft Office, Planning Skills.
Description :
Verified prior authorizations and/or pre-service requirements are met prior to the date of service for each service type.
Referred self-pay patients to Patient Financial Services in accordance with established guidelines.
Reviewed and resolved denial issues in a timely manner in accordance with established guidelines.
Verified current eligibility, benefits, and plan coverage in accordance with established guidelines.
Tracked and submitted retro-authorization requests, working closely with referring physician offices to resolve issues.
Utilized available tools and on-line resources to create efficiencies in the process.
Maintained ability to effectively utilize Microsoft Office (Outlook) and department-specific software applications to perform work.
Experience
5-7 Years
Level
Executive
Education
High School Or Equivalent
Insurance Authorization Specialist Resume
Objective : An Insurance Authorization Specialist professional with a track record of increased responsibility. Diverse experience in sales, treasury management, proficient in prioritizing and completing tasks in a timely manner, yet flexible to multitask necessary. Excellent problem-solving and negotiating skills. Able to make decisions independently and quickly with minimal escalations.
Skills : Microsoft Office, Planning Skills, Coordinating Skills.
Description :
Communicated effectively and cooperatively in the workplace.
Actively contributed to the achievement of Quality Improvement and Lean Process Improvement activities.
Completed all mandatory learning requirements in a timely manner.
Attended and actively participated in all department, team, and/or committee meetings.
Complied with all Skagit Regional Health, department, and location-specific policies and procedures.
Assumed responsibility for timely collection, update, and processing of authorizations.
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