A Medical Insurance Specialist manages the insurance services and several financial factors for patients. Certain core job duties associated with the role are listed on the Medical Insurance Specialist Resume as – processing medical insurance claims, medical coding, maintaining patient records in various healthcare settings, reviewing patient records using medical coding procedures, examining claims, verifying insurance eligibility, recording medical charges, and other payments; detecting any coding errors, performing any modifications; assisting patients in obtaining and understanding medical benefits, and undertaking responsibility for electronically storing, and organizing patient’s records, billing details, and registration forms.
Most of these professionals are generally skilled in all areas of medical billing, including medical coding, claims, and medical billing. Knowledge of computers, data entry, e-mail, and using the Internet is essential. Employers typically require prior work experience and the ability to multitask. The education requirement includes at least an associate’s degree from an accredited college, or a professional certification relevant to the discipline of work.
Objective : Objective is to always strive to give the best and offer that best possible work ethics that are in my ability to Render. Working accurately and efficiently to achieve a positive outcome to all objectives. Desire is to establish myself and have upward movement through perseverance, and hard work in a cohesive team oriented environment.
Skills : Accounts Payable, Billing.
Description :
Updated all insurance information for inpatients and outpatients stay.
Checked claim status regarding insurance claims sent.
Corrected all errors on rejected claims to ensure proper payments to hospital.
Interviewed patient for current or up dated insurance information.
Sent letters to patients inquiring payment options, if there is no insurance.
Called made regarding Medical and patient Collections, as well as calls received related to insurance and billing.
Performed various administrative functions utilizing various office machinery; Eagle 2000, Xerox copiers, faxes, and calculators.
Experience
2-5 Years
Level
Executive
Education
Bachelor Of Arts In Criminal Justice
Medical Insurance Specialist Resume
Objective : 4-year record of providing roles as Medical Office Specialist, Medical Insurance Specialist and Medical coder. Highly proficient with editing and composing a wide variety of written materials, analyzing statistical information, generating reports, and performing error free work. Proven ability to build and develop productive teams and streamline processes related to profitability and quality.
Skills : Computer Skills, Medical Billing
Description :
Responsible for ensuring the facility will be reimbursed for the procedures performed by calculating self-pay costs, verifying eligibility and benefits, obtaining authorizations and comparing procedures scheduled against insurance contracts and approved Ambulatory Surgery Center procedure listings.
Called and/or collected from payer or used payer websites to gain preauthorization information, eligibility, and benefits.
Acquired authorizations from vocational rehabilitation, insurance companies, or physician offices and ensured that all pertinent information was on the authorization.
Entered CPT codes along with authorization number of the authorized procedures into patient accounting system.
Confirmed insurance company approved procedures lists/medical policies.
Notified patient if the procedure is not payable.
Obtained signature on Medicare ABN or another non-covered notification form, if the patient wants to proceed.
Experience
2-5 Years
Level
Executive
Education
GED
Medical Insurance Specialist Resume
Summary : Dedicated Medical Insurance Specialist Professional with a versatile administrative support skill set. Excels in critical thinking with innovative solutions and implementation, with proven increased efficiency in operations. Offers superior customer service skills. Advanced computer skills in MS Office Suite and other applications.
Skills : Customer Service, Professionalism, Attention To Detail, Work Well Under Pressure, Data Entry, Quick Learner, Computer Skills, Flexibility, Strong Communication Skills, Strong Organizational Skills, Typing 65 WPM, Telephone Etiquette.
Description :
Provided excellent customer service.
Maintained pre-eligibility at two days ahead of all incoming appointments for primary location in order to troubleshoot insurance conflicts.
Ensured proper medical insurance coordination of benefits.
Assisted patients in obtaining necessary specialty office visit referrals.
Entered proper co-pay, co-insurance/deductible amounts for specialty office visits and out-patient surgery.
Educated patients on their medical benefits for their specific plan(s).
Assisted with pre-certifications for out-patient surgery.
Experience
7-10 Years
Level
Management
Education
Accelerated Studies
Medical Insurance Specialist Resume
Objective : Responsible for Calculating co-pay, and/or estimated deductible and co-insurance due from the patient by CPT code based on contracted amounts with the insurance company, and also Calculating self-pay costs according to facility-specific cash discount policy.
Skills : Customer Service, Medical Terminology, Sales, Microsoft Office, Typing 67 Words Per Minute 67 Wpm, Filing, Data Entry 10020 Key Strokes Per Minute, Organization, Time Management, Research, Phone Etiquette, Sales, Trigger Point Therapy, Swedish Massage, Deep Tissue Massage.
Description :
Reviewed insurance plans and verified coverage with customers and medical providers.
Reviewed completed claims and verified deductibles and confirmed claims processed correctly according to plan provisions.
Kept accurate notes of phone conversations in clients computer database and issues discusses during the phone calls.
Updated my knowledge of each companies insurance plans, changes, and also changes within the industry as well as state and federal requirements.
Worked with insured, medical providers, and employers to create a cohesive resolution to claim disputes and issues with policies and processing of claims.
Educated myself on the Meritain computer base to utilize tools in helping me to review claims and determine guidelines in processing so as to better assist clients when there was issues with their claims.
Promoted to the Performax Team (A specialized, and very sensitive client with very specific and difficult plans that changed frequently).
Experience
2-5 Years
Level
Junior
Education
MS
Medical Insurance Specialist Resume
Summary : Enthusiastic, resourceful, and self-motivated with academic and professional background in healthcare customer service. Ability to establish priorities and meet challenges head-on. Strong communication skills. Organized, independent worker with strong time-management skills. Over 7 years of experience in the healthcare customer service industry.
Skills : Microsoft Office, Customer Service.
Description :
Managed various general office duties such as answering multiple telephone lines, completing insurance forms and mailing monthly invoice statements to patients.
Demonstrated ability to lead, direct, and motivate the reception staff.
Provided patient education.
Collaborated with the claims department and industry anti-fraud organizations to resolve claims.
Followed up with the insured individuals regarding premium and deductibles payments.
Maintained contact with third party payers, claimants and attorneys to determine treatment status.
Experience
7-10 Years
Level
Management
Education
Associate Of Applied Science
Medical Insurance Specialist Resume
Summary : Highly qualified Medical Insurance Specialist with experience in the industry. Enjoy creative problem solving and getting exposure on multiple projects, and I would excel in the collaborative environment on which your company prides itself.
Actively prospected new clients and initiated group sales calls.
Specialized in medical insurance plan sales; answered questions and conducted presentations for renewals as well as potential new business.
Successfully penetrated challenging and immense geographic territory.
Established, enhanced, and maintained key accounts; grew assigned individual and group revenue base and converted non-participants to clients through business development and lead generation.
Initiated renewals for groups of two (2) or more.
Processed new enrollee and group renewal applications.
Handled cancellation forms.
Experience
10+ Years
Level
Senior
Education
High School Diploma
Medical Insurance Specialist Resume
Objective : To obtain a Medical Insurance Specialist position that will utilize my work experience and education while availing me with opportunities of advancement and professional development within the organization.
Skills : Medical Terminology Medical Basic and Healthcare Claim Cycle Basic Anatomy and PhysiologComputer Systems and Software Applications for the Medical Office Reimbursement Systems, ICD-9 codes and CPT codes, Medical Insurance Billing.
Description :
Came back to New Orleans to start rebuilding my home.} Insurance verification -eligibility and benefits, posted charges and payments both manually and electronically, obtained pre certifications and referrals.
Followed Up on Insurance and Attorney claims.
Determined appropriateness of codes and modifiers originally submitted for the service rendered and made changes as necessary using electronic chart information and paper chart information as the guide.
Recommended amendments and obtained clarifications from practice managers when necessary.
Submitted corrected claims when appropriate, assigning ICD-9-CM, CPT, HCPCS, and / or service codes when necessary.
Researched medical records and typed letters to Insurance carriers in order to establish medical necessity for surgeries performed, radiation treatment given and chemotherapy agents administered by doctors.
Researched the patient accounts to determine the final disposition of all inquiries and performed the appropriate system tasks to properly balance the account before billing a patient.
Experience
2-5 Years
Level
Executive
Education
Associate's
Medical Insurance Specialist Resume
Headline : To obtain a steady position with a company that would offer the opportunity for growth and advancement. I have knowledge of Timberline Software, Sage Software, Adobe, Microsoft Word, Excel, and QuickBooks. Current typing speed is up to 50 wpm. I am able to multitask and work in a fast-paced environment. I have strong communication skills and have plenty of customer service experience.
Audited/Analyzed and corrected any errors corresponding with underwriters and coding team.
Ensured Physician credentials are updated and current.
Minimized company loss of revenue by 20% and impacting collections of accounts receivables, lowering the days of AR from 120 days to 35.
Ability to analyze problems and create action plan to implement and correct system breakdowns.
Experience
5-7 Years
Level
Executive
Education
MS
Medical Insurance Specialist Resume
Headline : As a Medical Insurance Specialist, responsible for Typing up consultation notices and estimated charge amount letters, held confidential patient meetings in which I went over their insurance policies as well as their estimated charge amounts and answered any other questions they had pertaining to their medical services.
Skills : Microsoft Office, Advanced Technical Support.
Description :
Verified Patient's Eligibility, Benefits and Prior Authorization requirements for medical billing.
Updated Patient't insurance information into computer system for accurate billing.
Abstracted Charts to assess qualifications on new accounts and reacted accounts.
Answered questions from customers and other associates over patient's eligibility and claim processing.
Investigated into claim rejections that are not received by insurance companies electronically.
Assessed billing documents and requirements for submission of claims for Private Insurance, Medicaid and Medicare patients.
Followed up with insurance companies on claims to ensure documentation is complete and accurate.
Experience
5-7 Years
Level
Executive
Education
A.A.S In Health Information Management
Medical Insurance Specialist Resume
Objective : To secure a position with a corporation/company that allows me to contribute my customer service, computer, and guest relations skills.
Creating an account is free and takes five seconds.
You'll get access to the PDF version of this resume template.
Choose an option.
Sign up with Google
Sign up with Facebook
Sign up with Linkedin
This helps us make sure you're human and prevents spammers from abusing our services.
By continuing, you agree to our Privacy Policy and Terms.
Unlock the Power of Over 10,000 Resume Samples.
Take your job search to the next level with our extensive collection of 10,000+ resume samples. Find inspiration for your own resume and gain a competitive edge in your job search.
Get Hired Faster with Resume Assistant.
Make your resume shine with our Resume Assistant. You'll receive a real-time score as you edit, helping you to optimize your skills, experience, and achievements for the role you want.
Get Noticed with Resume Templates that Beat the ATS.
Get past the resume screeners with ease using our optimized templates. Our professional designs are tailored to beat the ATS and help you land your dream job.
