An Insurance Verification Rep works to ensure that the patient’s healthcare benefits are properly covered by the procedures. The job description entails verifying the patient’s insurance information and explaining the benefits to the customers. Responsibilities commonly found on the Insurance Verification Rep Resume are – verifying patient insurance coverage, accurately entering data, updating patient information, arranging payment for services not covered under insurance, discussing different financing options to fit patient’s budgets; and undertaking administrative duties.
The nature of the work demands the following skills – experience working with insurance companies, knowledge of different types of coverage and policies; excellent multitasking skills, the ability to maintain accurate patient insurance records; working knowledge of medical terminology. A high school diploma along with healthcare billing experience is preferred.
Headline : Seeking a Insurance Verification Rep position where my training, motivation, organization and people skills can add to the success of the industry.
Responsible for verifying insurance coverage, eligibility, benefits, obtaining authorizations and pre-certs as required by the payer.
Calculated co-insurance estimates per the payer contract.
Notified surgery centers of needed documentation and or authorizations/referrals from doctor offices.
Entered the verification, eligibility and benefit information in the patient accounting system.
Documented the amount expected from the patient on or before the date of service.
Responsible for communicating insurance benefit information and financial responsibility to each patient due the Pre-Registration Financial Orientation call prior to date of service.
Verified patient demographics and insurance information.
Answered incoming calls with patient questions and or complaints.
Experience
5-7 Years
Level
Executive
Education
Certificate In Career Education
Insurance Verification Rep Resume
Summary : Insurance Verification Rep (IR) is responsible for verifying that insurance claims are paid. The IR provides customer service and assistance to insurance customers. This includes providing information on policies, submitting claims, and resolving issues.
Skills : Medical Records, Customer Service.
Description :
Served as a liaison between the hospital and patient with financial arrangements resulting in decreased debt.
Communicated successfully with patients leading to the establishment of payment arrangement with patients.
Adhered to the HIPAA regulations when verifying pre-authorization on inbound calls.
Responsible for interpreting hospital and medical insurance services and benefits to personnel who contract hospital insurance.
Processed medical claims with special emphasis on inpatient accounts.
Billed claims through SSI and worked rejections.
Claims auditor for all accounts requested by insurance companies.
Experience
10+ Years
Level
Senior
Education
Diploma
Insurance Verification Rep Resume
Summary : Results-driven, dedicated professional with solid experience in the Customer Service. Insurance Verification Rep is responsible for verifying insurance coverage for new business clients.
Skills : Data Entry, Email, Filing, Fax, Outlook, Powerpoint, Typing, Training, Vital Signs, Windows Xp.
Description :
Responsible for performing financial clearance of patient accounts.
Communicated with insurance companies for the purpose of collecting information necessary for hospital admission.
Pre-screened all accounts to ensure required data fields are correct and pre-code scheduled procedures.
Verified patient insurance eligibility and benefits using technology tools, the phone and the internet.
Worked closely with Financial Counseling to assist in the identification of patient liabilities.
Entered the appropriate documentation and select the correct activity code resulting in proper transmission of necessary information back to the facility for processing when the patient is present at the facility.
Coordinated with the insurance providers, departments, and doctor offices to obtain referrals and pre-authorizations.
Experience
10+ Years
Level
Senior
Education
Diploma
Insurance Verification Rep Resume
Objective : To obtain a long-term Insurance Verification Rep position in an organization where I can maximize my customer service experience in a challenging environment.
Responsible for calling insurance companies to verify benefits in a timely manner.
Verified copays, deductibles & out of pocket expenses & coinsurance.
Answered incoming calls from patients to update insurance information & all insurance questions.
Responsible for printing daily schedules for departments.
Cons stented enter benefits in computer system & notes where necessary.
Operated office machines such as fax, printer & copier.
Familied with benefit verification procedures on Commercial, Medicare, Medicaid, HMO, PPO, POS, EPO & other insurances.
Experience
2-5 Years
Level
Consultant
Education
High School Diploma
Insurance Verification Rep Resume
Objective : To obtain a challenging and rewarding Insurance Verification Rep position that allows for personal growth as well as growth within the school system.
Skills : Excel, Word, access, Office Equipment, Office Administration,.
Description :
Scanned insurance cards and other important documents real-time.
Collected and posted co-pays and any past-due balances, and reconciled money at end of shift.
Scheduled and registered for initial and follow-up appointments (utilized the I guide to determine participation).
Confirmed authorization and/or collected referrals for the day visits.
Demonstrated computer competency including, but not limited to, scheduling walk-in visits, appointment cancellations and order entry for clinical system.
Worked collaboratively with insurance plans, clinical staff, Central Business Office, financial counselors, etc., to ensure coverage and payment are obtained for all services rendered.
Identified trends and alerted managers and supervisors to plan benefit changes that may affect services.
Experience
2-5 Years
Level
Junior
Education
Diploma In Medical
Insurance Verification Rep Resume
Summary : Results-driven Insurance Verification Rep with experience managing organizational performance and multimillion-dollar organizations. Dynamic leader accomplished in design and implementing strategies that enhance organizational growth and sustainability. Expertise in development of organizational programs, service and projects.
Skills : Microsoft Word, Bright Tree, software, Microsoft Excel, Microsoft Outlook, Microsoft Power Point, Typing 50+ WPM.
Description :
Verified insurance carrier liability and claimants in accordance with policy provision.
Troubleshooted and reconciled problem claims.
Provided extensive relations and customer service to patients.
Liaised between provider and member home-plan.
Processed COBRA claims and verifying premiums.
Processed PPO/HMO and Indemnity verifying valid DX and CPT codes.
Worked with the federal Medicaid and Medicare programs to verify private insurance coverage of patients to ensure proper billing.
Researched info through online and telephone and entered data into several databases daily.
Experience
7-10 Years
Level
Management
Education
Business Administration
Insurance Verification Rep Resume
Headline : Insurance Verification Rep will be responsible for verifying insurance coverage and ensuring that the clients claims are processed in a timely manner.
Skills : Bilingual: Spanish. EMR Aprima, eClinicals, AiMed and IMS. Microsoft Word, Outlook, Medical Manager, Filebound, Office Hours, Medisoft.
Description :
Obtained authorization for all insurance carriers for all outpatient office visits and procedures scheduled within the Health Systems.
Directed impacts patient care, patient satisfaction and the revenue cycle.
Responsible for the on-site insurance verification process.
This individual reports directly to the Insurance Verification Supervisor.
Tracked company for various lending institutions, tracked hazard insurance on homeowner loans.
Processed work items through exception queues.
Updated hazard insurance policies on homeowner loans and conducted research as needed.
Conducted random audits on new hires and had side by sides to review audits/correct errors.
Experience
5-7 Years
Level
Executive
Education
Associates In Health Care
Insurance Verification Rep Resume
Objective : Obtaining a responsible Insurance Verification Rep position that will strengthen my knowledge and skills in the ever-changing health care environment. Highly motivated, goal-oriented health care professional and able to adapt and learn quickly in the health care environment.
Contacted large carrier groups to obtain eligibility information from our internal lead sources and update the data into internal system.
Answered incoming calls from providers, recipients, and other entities in relation to insurance coverage.
Made outbound calls to various carriers to obtain eligibility information.
Researched eligibility information online with various carriers and update the state eligibility system.
Conducted insurance verification interviews with new customers, agents, and brokers.
Ensured all claims are processed in a timely manner.
Experience
0-2 Years
Level
Entry Level
Education
BS In HealthCare
Insurance Verification Rep Resume
Summary : Insurance Verification Rep is responsible for verifying insurance claims, and ensuring that the claims are processed accurately. This includes verifying the facts of each claim, determining eligibility and coverage, and issuing a timely payment. This position also includes working with attorneys to resolve claims in a timely manner.
Skills : Customer Service, Medical Records, Health Care.
Description :
Verified and processed insurance claims as per policy requirements.
Provided customer service to customers and resolve issues related to the insurance company policies.
Provided product knowledge by answering questions related to the insurance company products.
Developed a relationship of trust with customers by providing timely and accurate information.
Provided customer service at times when the product is not available or in areas where the customer cannot access it due to time constraints or location restrictions.
Assisted with customer satisfaction surveys, audits, reports, evaluations, etc.
Assisted with establishing new accounts through over the phone support as needed.
Experience
7-10 Years
Level
Consultant
Education
Graphic Design
Insurance Verification Rep Resume
Objective : To find a Insurance Verification Rep position with a variety of challenges and responsibilities where I can use my strong interpersonal and organizational skills to excel. Assist with training new employees in sales, marketing, and legal functions as needed.
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