The Insurance Verifier is an employee working typically at a healthcare or medical facility who takes the responsibility of dealing with the patient’s insurance claims and its related billing. The step-by-step duties performed by these verifiers are mentioned on the Insurance Verifier Resume as follows – going through the patient’s insurance information, verifying if the process or procedure is covered under the policy or not, sending proper documentation to the insurance company, working with the insurance company to bill and negotiate the claims, communicating with patients about co-pays, coverage, and care authorization; entering data, creating reports and validating cross-patient information; and liaising with insurer and patients.
Due to the work culture, the job applicants are supposed to demonstrate these skills to get qualified for this role – a high level of accuracy and strong attention to details, a very good knowledge of insurance processing and handling billing disputes; basic understanding of bookkeeping, familiarity with medical codes and sound communication skills. A high school diploma is mandatory, but employers want a post-secondary medical education as well.
Headline : An adaptable, resourceful and enthusiastic individual with experience in the health care system. Approach is to integrate knowledge and experience in the clinic or hospital setting for an ambitious and expanding company, Ability to relate to people (both in person and on the phone) in a pleasant, businesslike manner.
Skills : Typing 65wpm, Proficient with basic.
Description :
Responsible for ensuring the facility will be reimbursed for the procedures performed by verifying eligibility and benefits, calculating self-pay costs, obtaining authorizations, and comparing procedures scheduled against insurance contracts, and approved ASC procedure listings.
Facilitated coordination of budget plans and pre-payment arrangements.
Communicated financial information to patients and documenting in the patient accounting system.
Managed accounts receivable to ensure timely, accurate billing, and reimbursement of patient accounts.
Responsible for providing direct support to the top three leading surgery centers in the Southern region.
Performed follow-up on all unprocessed claims to obtain resolution of billing issues within 24 hours of claims dropping into SSI billing system.
Managed calls on the insurance line from patients, clients, physicians, practitioners, and clinics regarding inquiries about services provided, financial responsibility, and insurance coverage.
Experience
5-7 Years
Level
Executive
Education
Medical Assistant
Jr. Insurance Verifier Resume
Objective : An insurance verifier is a health care professional working to ensure that patients' health care benefits cover required procedures, Must have the skills necessary to operate the office equipment required to fulfill job duties.
Skills : Organization, Program planning, information delivery, Program evaluation, Needs assessment, Presentation, Microsoft Office, Internet/Email, Type 50 WPM.
Description :
Interfaced with Insurance Companies with regard to coverages.
Contacted Insurance companies and obtained referrals to Specialists and obtained pre-certification for numerous procedures.
Prepared Hospital charges for the doctor to submit to accounting.
Responsible for obtaining medical benefits and pre-authorizations for in-patient hospital services via the telephone, internet, and fax server.
Utilized Ace On Demand and IMAC billing software for processing of claims and payments Post payments and provide follow up for all tenant facilities within and outside of Texas.
Performed insurance verification and pre-certification follow up for the prior day's walk-in admissions/registrations and account status changes by assigned facility.
Verified insurance for new patients Answer phones Medicare Accreditation.
Experience
2-5 Years
Level
Junior
Education
MA In Teaching
Lead Insurance Verifier Resume
Summary : Fast learner with the ability to work both as a team member and an individual with little or no supervision. Possess detail orientated, multi-tasking, problem solving, communicative, and creativity skills.
Skills : Faxing, Making copies, and Answering phones.
Description :
Verified health insurance coverage for patients.
Assisted in meeting daily team quotas.
Built relationships with co-workers which translated into better teamwork.
Used Bilingual, passionate, positive perspective, very dependable and coachable and open-minded.
Utilized all-payer websites to be more timely and accurate obtaining data.
Verified demographics with patients and informed them of their out of pocket benefits that were due at the time of service.
Verifying patient's insurance and dropping benefits & eligibility into patient's file, reviewing appeals requests and claims for patients charts, checking over any outstanding balances, calling insurance companies to verify out of network patients.
Experience
7-10 Years
Level
Management
Education
Business Finance
Insurance Verifier I Resume
Objective : Proven track record of providing essential executive thinking and demonstrating leadership versatility. Strong interpersonal and organizational skills with a keen ability to multitask a variety of challenges and responsibilities.
Skills : Microsoft Office, EMR, Fax Machine, Computer, As400.
Description :
Recorded and processed orders and/or inquiries received by fax, mail, telephone, and/or through patient direct contact.
Provided timely response to patients' inquiries by telephone and/or email in an in or outbound service center, consistent with service and quality standards.
Provided pricing, availability, and schedules information within established guidelines.
Received inbound and outbound calls to patients or MD Offices regarding orders for medications, pharmacy services and all other inquiries.
Processed and corrertly triaged Limited Distribution Drugs.
Advised and assisted local retail store with Rejections from patient insurance plans.
Coordinated patient care by scheduling orders, communicating information to the patient regarding shipments, assessing supply needs, verifying patient information, notifying the pharmacist of issues or changes in the patient's condition.
Experience
2-5 Years
Level
Junior
Education
GED
Insurance Verifier/Specialist Resume
Summary : Seeking a position with a well-established company that offers an opportunity for advancement. A challenging position where knowledge, and experience; can utilize to create innovative solutions, and meaningful results.
Assessed each new hires area for improvement then encourage the individual's growth, development, and improvement.
Reported carrier issues using the proper forms and communication channels.
Verified insurance policies (as requested) and maintain a quality score of 95% accuracy or better.
Suggested areas for process and procedural improvement and report to Supervisor.
Performed internal department production audits.
Make 80-100 outbound calls to insurance agencies and insurance carriers to verify policy coverage, on behalf of the mortgagee, on personal homeowners and commercial properties.
Updated policy account information into the internal system Fax and email requests to insurance agencies for declarations, evidence of insurance, and certificate of insurance documents.
Experience
7-10 Years
Level
Management
Education
High School Diploma
Insurance Verifier/Representative Resume
Objective : Effective at conveying ideas; Professional who loves to work with people; Team Building; Quality Customer Care, Ability to utilize Electronic Health Care Record system for documentation to patients account/record.
Good attention to detail. Self-starter and works independently.
Skills : Customer Service, CNA Health Care, Retail, and Manufacturing.
Description :
Obtained and verified insurance eligibility for services provided and document complete information in system.
Collected any clinical information such as lab values, diagnosis codes, etc.
Determined patient's financial responsibilities as stated by insurance.
Configured coordination of benefits information on every referral.
Ensured assignment of benefits are obtained and on file for Medicare claims.
Billed insurance companies for therapies provided.
Documented all pertinent communication with patient, physician, insurance company as it may relate to collection procedures.
Experience
2-5 Years
Level
Junior
Education
A.S In Business
Insurance Verifier/Executive Resume
Objective : To obtain a challenging position in a growth-oriented organization that will utilize skills to create a successful work environment, 2-3 years of healthcare Insurance Verification experience required.
Technical, critical thinking, and interpersonal skills relevant to area in order to effectively communicate with physicians, health team members, patients and families.
Skills : Insurance Verification, Data Entry, Medical Terminology.
Description :
Obtained precertification for MRI procedures.
Interviewed and registered the patient upon arrival.
Scaned all patient documents in patient file.
Contacted insurance providers for verification of coverage Confirmed coverage of patient-specific procedures Verified variable co-payment amounts.
Efficiently performed insurance verification, pre-certification and pre-authorization Functions.
Prepared and attached all required claims documentation including referrals, And other required correspondence to reduce the incidence of denials.
Strictly followed all federal and state guidelines for the release of information.
Experience
2-5 Years
Level
Junior
Education
Diploma
Insurance Verifier/Coordinator Resume
Objective : Enthusiastic, Organized and Analytical Excel in Fast Paced Environments 10+ Years Experience with Administrative/Office Operations 2 Years Experience as Accounting Clerk 1+ Year Experience with Legal Office Operations.
Calculated patient financial responsibility estimated upon the surgeon's orders.
Contacted patients with estimated financial responsibility 5 to 7 days prior to surgical procedure.
Discussed insurance coverage and payment options with patients, offered Care Credit for an additional source of payment.
Contacted surgeons' offices for additional information as required.
Backed up the Registrar position on a regular basis.
Assisted Business Office Manager and Center Administrator with any projects as needed.
Verified coverage for patients that had Private insurance (Blue Cross Blue Shield, Cigna, Aetna, and etc.), Medicaid, and Medicare.
Experience
2-5 Years
Level
Executive
Education
Diploma
Insurance Verifier III Resume
Summary : Seeking a position with an office, which would permit an opportunity to demonstrate experience in insurance verification, admitting, registration, customer relations, reception and all basic business office skills.
Skills : Billing/collections for Medicare, Medicaid, HMO's.
Description :
Calculated and Notified the patient of financial responsibility.
Confirmed and obtained proper authorizations, and letters of Agreement for non-contracted Insurances.
Obtained tracking numbers for outpatient facility charges.
Made sure all in patient and outpatient procedures are pre-certified.
Input correct CPT and ICD-9 codes are put into the system for each procedure.
Obtained proper codes and pre-certifications for each patient before procedures.
Responsible for obtaining benefits and authorization for emergency room admits, radiology, and pre-admit patients scheduled for a procedure.
Experience
7-10 Years
Level
Management
Education
Medical Assistant
Lead Insurance Verifier Resume
Headline : A challenging position in the medical field or any related position with an organization which will encourages the growth of professional skills.
Skills : Customer Service, Organization, Team Player.
Description :
Verified patients benefits for the next day service.
Updated patient demographics/information in system.
Verified insurance benefits, obtaining proper authorization from insurance carrier.
Determined what funds to collect upon admission.
Notified patients of monies due and document in billing system This position also requires scheduling of all radiology procedures as required by the demand of the appointment.
Knowledged of working a collection queue for maximum reimbursement.
Communicated with Radiology site what to collect for patient procedures.
Experience
5-7 Years
Level
Executive
Education
Diploma
Insurance Verifier Resume
Summary : To gain enough knowledge and experience as well as put forth level of skill to professionalize in the business management field. Highly motivated individual with expertise in sales and customer service and Medical field.
Skills : Distinguished performance, Self motivated, Responsible Functional, Good Learner.
Description :
Managed all incoming calls and provided required information.
Gathered information from insurance companies to obtain authorizations for surgery.
Maintained surgery schedule and update date and time on it.
Coordinated with materials manager to complete all surgeon requests.
Maintained surgery schedule and update date and time on it.
Performed prior authorizations as required by payor source.
Included procurement of needed documentation by collaborating with physician offices and insurance companies.
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