Insurance Verification Specialist Resume Samples

Description :

1. Managed patient insurance verification processes, ensuring accurate eligibility checks.
2. Scheduled and confirmed patient appointments, coordinating with insurance providers.
3. Greeted patients and directed them to appropriate staff for assistance.
4. Utilized office software to prepare reports and maintain patient records.
5. Interviewed patients to gather necessary insurance information for claims.
6. Received and routed messages, ensuring timely communication with healthcare staff.
7. Transmitted medical records and correspondence securely via email and fax.

Experience

2-5 Years

Level

Junior

Education

AAS HIT

Description :

1. Verified patient eligibility and benefit information for appointments, ensuring accurate data for Family Practice and Cancer Therapy.
2. Updated patient demographics in Epic and IDX systems for new accounts, enhancing data integrity.
3. Collected necessary insurance information for clinical services, facilitating smooth patient care.
4. Coordinated with PCPs and HMO payers to initiate care authorizations, completing requests within 48 hours.
5. Collaborated with clinic managers to resolve scheduling and insurance-related issues, improving operational efficiency.
6. Communicated potential issues to supervisors proactively, ensuring timely resolutions.
7. Handled incoming calls from multi-specialty clinics for verification of walk-in patients using Cisco Agent.

Experience

2-5 Years

Level

Junior

Education

AAS-HIT

Description :

1. Verify patient insurance coverage for medical supplies and services, ensuring compliance with policy requirements.
2. Communicate with insurance companies to confirm coverage details and authorization needs for specific treatments.
3. Collaborate with healthcare providers to obtain necessary referrals and clinical documentation for insurance claims.
4. Accurately input patient demographics and insurance information into electronic health records.
5. Maintain detailed records of insurance notes and documentation for audit purposes.
6. Process medical supply orders efficiently, ensuring timely delivery to patients.
7. Assist patients with payment options for non-covered services, providing clear information and support.

Experience

7-10 Years

Level

Senior

Education

AAS HIT

Description :

1. Verify patient insurance coverage and benefits by contacting insurance providers directly.
2. Resolve discrepancies in patient information to ensure accurate billing and claims processing.
3. Maintain detailed records of insurance verifications and communications for compliance purposes.
4. Assist patients with inquiries regarding their insurance coverage and claims status.
5. Collaborate with healthcare providers to obtain necessary documentation for insurance claims.
6. Utilize electronic health record systems to update patient information and insurance details.
7. Train new staff on insurance verification processes and best practices.

Experience

2-5 Years

Level

Junior

Education

AAS-HIT

Description :

1. Executed insurance verifications for all scheduled patients, ensuring accurate data entry.
2. Obtained and confirmed correct insurance information and benefits for optimal patient care.
3. Maintained comprehensive lists of requirements from various insurance providers.
4. Secured authorizations for all inpatient admissions, enhancing service delivery.
5. Registered patients for sleep studies and coordinated pre-registration paperwork for outpatient surgeries.
6. Provided daily surgery reports to the Outpatient Registration team for efficient scheduling.
7. Ensured timely registration of all patients, both scheduled and unscheduled, to improve patient flow.

Experience

7-10 Years

Level

Management

Education

AAS-HIT

Description :

1. Conduct thorough insurance verifications for multiple providers, ensuring accurate coverage details.
2. Maintain detailed records of verification processes and outcomes to support claims management.
3. Analyze insurance policy terms to confirm coverage for specific claims and services.
4. Communicate with clients to clarify coverage details and resolve discrepancies in claims.
5. Collaborate with healthcare providers to gather necessary documentation for claims processing.
6. Identify and address issues in the verification process to enhance efficiency and accuracy.
7. Lead a team of verification specialists, providing training and support to improve performance.

Experience

7-10 Years

Level

Management

Education

B.S. Health Admin

Description :

1. Collected and verified insurance and demographic data to ensure accurate billing for patient encounters.
2. Utilized online verification services and contacted insurance carriers to confirm patient benefits.
3. Entered insurance and demographic information into the billing system with high accuracy.
4. Provided guidance to health center staff regarding insurance eligibility and benefits.
5. Generated patient schedule reports to identify and resolve eligibility issues prior to service dates.
6. Communicated co-payments, benefit limitations, and deductibles to relevant departments via alert notes.
7. Secured necessary authorizations for procedures performed at healthcare facilities.

Experience

0-2 Years

Level

Entry Level

Education

AAS-HIT

Description :

1. Verified patient insurance coverage for various medical procedures, ensuring accurate billing.
2. Gathered detailed information from insurance providers regarding co-pays, deductibles, and coverage limits.
3. Initiated and managed medical authorizations for procedures using CPT-4 and ICD-10 codes.
4. Collaborated with healthcare providers to resolve authorization issues and streamline processes.
5. Registered patients for inpatient, outpatient, and emergency services, ensuring compliance with insurance requirements.
6. Provided concierge-level service to patients visiting the Patient Access Department.
7. Collected co-pays and discussed billing inquiries with patients, enhancing their understanding of financial responsibilities.

Experience

0-2 Years

Level

Entry Level

Education

AAS-HIT

Description :

1. Facilitated effective communication with clients and insurance providers to verify coverage and benefits.
2. Conducted thorough insurance verifications to ensure coverage for necessary medical procedures.
3. Initiated and managed prior authorizations for medical equipment and services.
4. Educated patients and healthcare providers on insurance coverage details and requirements.
5. Maintained consistent follow-ups with patients and insurance companies to resolve issues.
6. Ensured compliance with HIPAA regulations while managing sensitive patient information.
7. Developed strong relationships with insurance adjusters and healthcare representatives to expedite claims processing.

Experience

5-7 Years

Level

Executive

Education

AAS-HIT

Description :

1. Conduct thorough insurance verifications to confirm patient coverage and eligibility.
2. Input and maintain accurate patient data, including demographics and insurance details.
3. Review insurance policies to assess coverage and benefits for patients.
4. Communicate with patients and insurance providers to gather necessary information.
5. Ensure the confidentiality and security of sensitive medical records.
6. Audit records for accuracy and compliance with healthcare regulations.
7. Collaborate with healthcare providers to resolve discrepancies in patient information.

Experience

5-7 Years

Level

Consultant

Education

A.S. in H.I.

Description :

1. Verified insurance coverage for patients, ensuring accurate billing and compliance with regulations.
2. Processed insurance claims and managed follow-ups to resolve discrepancies and expedite payments.
3. Maintained detailed records of patient interactions and insurance communications for audit purposes.
4. Collaborated with healthcare providers to gather necessary documentation for claims processing.
5. Conducted regular audits of insurance claims to identify trends and areas for improvement.
6. Provided exceptional customer service, addressing patient inquiries regarding insurance coverage and claims status.
7. Trained new employees on insurance verification processes and best practices.

Experience

10+ Years

Level

Senior

Education

AS-HIT

Description :

1. Accurately verifies patient insurance coverage and enters data into electronic health records.
2. Facilitates prior authorization requests, ensuring timely approvals for necessary treatments.
3. Communicates with patients and healthcare providers regarding insurance benefits and financial responsibilities.
4. Conducts thorough reviews of insurance policies to confirm coverage for medications and services.
5. Collaborates with pharmacy teams to resolve issues related to medication coverage and billing.
6. Maintains up-to-date knowledge of insurance regulations and compliance standards.
7. Handles inbound and outbound calls to gather information and provide support to patients and providers.

Experience

0-2 Years

Level

Entry Level

Education

AS-HIM