Benefits Verification Specialist Resume Samples

The job description for the post includes working under the supervision of a management team and contacting insurance companies, to verify the patient’s specific benefits. A well-drafted Benefits Verification Specialist Resume mentions the following core tasks – asking appropriate questions regarding the benefits a patient can avail, completing data entry tasks, documenting all information, collecting and verifying patient information, identifying restrictions, completing quality review, and precisely documenting various payer plans such as patient coverage, access options, and cost-share.

The required skills include – the ability to work in a fast-paced environment; strong interpersonal skills, strong attention to details; working knowledge of MS Office, proficient Windows-based experience with strong fundamentals of typing and data entry; experience in fields such as case management and social services; and solid knowledge of Medical Administration. A high school diploma or GED is minimally required.

 

Benefits Verification Specialist Resume example

Benefits Verification Specialist Resume

Headline : Efficiently, Accurately and expeditiously enters and updates demographic and insurance data in practice and management system. Complete online insurance verification when applicable or verify insurance by phone. -Accurately and efficiently operates the cash register, providing various services at the customer service counter. -Performs duties of floor monitor when one is not assigned to be on duties.

Skills : -Excellent Multitasking Skills -Willingness To Participate In And Successfully Complete Any Required Training And To Work With The Team To Increase Customer Satisfaction And Sales.

Description :

    1. Collected and reviewed all patient insurance benefit information, to the degree authorized by the SOP of the program.
    2. Provided assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications.
    3. Completed and submited all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third party payors.
    4. Researched and resolved any electronic claim denials.
    5. Researched and resolves any claim denials or underpayment of claims.
    6. Effectively utilized various means for collections, including but not limited to phone, fax, mail, and online methods.
    7. Provided exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
Certified Medical Office Assistant


Sr. Benefits Verification Specialist Resume

Objective : Over 5 years of experience successfully providing administrative and support services to the operations department. Proficient in a range of computer applications. Well-developed communication and customer service skills. Proven ability to efficiently plan and manage multiple assignments to meet tight deadlines. A proactive problem-solver who gets the job done. Administrative/Support Services.

Skills : File and record maintenance, type 65 WPM, intermediate.

Description :

    1. Contracted Position Collected and reviewed all patient insurance benefit information, to the degree authorized by the SOP of the program.
    2. Maintained frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers.
    3. Provided all necessary documentation required to expedite payments.
    4. Coordinated with inter-departmental associates to obtain appropriate medical records as they relate to the reimbursement process.
    5. Verified insurance benefits for commercial, Medicare, and Medicaid Payers (Phone and Website) Assisted in both day-to-day and special projects and performs other duties as assigned.
    6. Determined primary and secondary payers Followed all HIPAA requirements.
    7. Maintained confidentiality in regards to patient account status and the financial affairs of the clinic/corporation.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Executive
Education
Education
Bachelor Of Arts


Jr. Benefits Verification Specialist Resume

Objective : Seeking an Office Administration Specialist position related opportunity where professional and educational skills may be utilized within a reputable company in a positive environment.

Skills : Accounts Receivable, Customer Service, EDI, Order Processing, Commercial Collections.

Description :

    1. Provided dedicated, personalized support delivered over the phone and via our online portal.
    2. Reviewed clinical documents for prior authorization/pre-determination submission purposes.
    3. Contacted referral source, patient, and/or doctor’s office to obtain additional information that is required to complete verification of benefits or prior approvals.
    4. Verified and documented insurance coverage of medications, administration supplies, and related pharmacy services including prior authorization requirements and coordination of benefits.
    5. Placed outbound calls to patients or doctor’s offices to notify of any delays due to more information needed to process or due to a prior authorization.
    6. Provided exceptional customer service to external and internal customers, resolving any customer requests in a timely and accurate manner.
    7. Ensured the appropriate notification of patients in regards to their financial responsibility, benefit coverage, and payor authorization for services to be provided.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
Business Management

Benefits Verification Specialist III Resume

Summary : Resourceful team player with excellent planning and organizational skills, along with a high degree of detail orientation. looking for a position with opportunities for growth and where can contribute to team excellence.

Skills : Customer Service, Communication, Retail Services, Coaching.

Description :

  • Responsible for verifying insurance coverage for new patients and re-verifying for existing patients.
  • Processed claims using drug cards or processing benefits under major medical benefits.
  • Initiated and submitted prior authorizations, and ensuring the delivery of specialty medications.
  • Effectively provided database updates on specified regional insurance carrier formulary updates.
  • Explained insurance coverage and copay structure information to external customers.
  • Bridged communications between health insurance providers and health care providers through verbal communication and support documentation.
  • Analyzed health insurance policies for the drug Orencia to determine reimbursement eligibility and patient coverage.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
Pharmacy Technology

Benefits Verification Specialist II Resume

Objective : To pursue employment where strength as Customer Service Specialist can be utilized while offering the potential for advancement based on positive job performance. Distributes materials to the identified bereaved receiving services in accordance with the bereavement plan of care.

Skills : Microsoft Office, Data Entry, Typing, Customer Service.

Description :

    1. Provide dedicated, personalized support delivered over the phone and via our online portal.
    2. Completed investigation of insurance benefits, including information about coverage and out-of-pocket costs; Provide answers to questions about insurance coverage while completing Benefit Verifications for patients.
    3. Collaborated with patient and doctor to assist with issues related to payments, Reimbursements, payment denials, and appeals and Prior Authorizations.
    4. Responded to inquiries from customers, sales representatives and business partners, and follow up on requests in a timely, courteous and professional manner.
    5. Maintained a positive attitude and a helpful approach to customers and clients.
    6. Entered orders, change orders, track shipments, and enter customer notes as appropriate to complete the customer/consumer transactions.
    7. Assisted in training of new employees and special projects as required Accomplishments Maintained above 90% quality rating.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Executive
Education
Education
Business Management

Benefits Verification Specialist I Resume

Objective : To obtain employment in a professional office environment that will allow utilizing knowledge, skills, and training acquired via work experiences in various capacities in General, Medical, and Real Estate Office Administration, working with businesses that impact the lives of the families they serve with optimal outcomes.

Skills : Microsoft Office/ Windows, Customer Service, Payroll, Billing, Data Entry, Medical Terminology, Claims Processing, Insurance.

Description :

    1. Verified insurance coverage for both new and existing patients.
    2. Collected the appropriate information needed to ensure insurance coverage for patient medication orders and documents in computer systems.
    3. Processed patient prescription needs successfully, reduce exposure and demonstrate excellent customer service to patients, healthcare professionals, and insurance carriers.
    4. Contacted insurance carriers to resolve Electronic Claim Submission rejections and Major Medical coverage issues.
    5. Secured and verified a method of payment for a patient's financial responsibility.
    6. Reviewed the billing system to verify the patient's eligibility to receive medication and update the necessary information.
    7. Obtained accurate demographic, insurance and financial information from healthcare professionals and patients to complete enrollment applications for new patients.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Executive
Education
Education
Associate

Assistant Benefits Verification Specialist Resume

Objective : Highly qualified Benefits Verification Specialist with experience in the industry. Enjoy creative problem solving and getting exposure on multiple projects, and would excel in the collaborative environment on which your company prides itself.

Skills : Training & Development, Lean Six Sigma.

Description :

    1. Verified Insurance benefits for Home Infusion Therapy for discharged patients.
    2. Accomplished the received referrals in a timely manner for the patient to have the therapy needed.
    3. Verifiied Verify Benefits Process Claims Update Patient Demographics.
    4. Contacted insurance companies on behalf of the physician office to verify patient benefits Respond to insurance inquiries from public and private payers.
    5. Responsible for making outbound calls to payers to obtain benefits information for the patient; once obtain data entry information to be.
    6. Provided assistance to physician office staff and patients to complete and submit all necessary insurance forms and programs.
    7. Received medication referrals and collects insurance information via multiple methods, runs test claims, and completes administrative duties.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Executive
Education
Education
Political Science

Benefits Verification Specialist/Coordinator Resume

Summary : To obtain a challenging position that offers the opportunity to utilize skills and experience to assist an organization. Proven track record of seven years in customer service incorporating Customer Satisfaction, Customer Demand, Continuous process, and Quality Awareness within Company standards.

Skills : Customer Service, Freight Brokering, Data Entry, Typing, Insurance Benefit Investigation, Logistical Management, Negotiations, General Office.

Description :

    1. Verified insurance benefits for specific drugs and created a summary of benefits for medical office/hospital facility.
    2. Multi-tasked and high production between different screens and various outbound/inbound calls.
    3. Performed a thorough verification of benefits using the Patient Plus management suite Examined in detail everything from coverage requirements too.
    4. Inverted organization chart. Our clinical teams are at the top and our CEO is at the bottom supporting our organization
    5. Oversaws bereavement follow-up by patient care staff and volunteers.
    6. Documented and initiated prior authorization process and claims appeals.
    7. Reported any reimbursement trends or delays to management.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
Bachelor In Microbiology

Benefits Verification Specialist/Manager Resume

Summary : Oriented Customer Service Professional for 15+ years. Worked within the call center industry for more than 10 years for different domains. Proven expertise in handling more than 100 inbound calls on a daily basis. Experience in providing excellent customer care using one-call resolution and in a professional manner.

Skills : Sales, Powerpoint, Google Docs, Customer Service, Word, Microsoft Outlook.

Description :

    1. Provided assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications.
    2. Completed and submits all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third party payors.
    3. Researched and resolved any claim denials or underpayment of claims.
    4. Effectively utilized various means for collections, including but not limited to phone, fax, mail, and online methods.
    5. Contacted public and private insurance providers on behalf of physicians to verify patients' benefits Acquired, verified and entered patients' drugs.
    6. Verified patient specific benefits and precisely documents specifics for various payer plans including patient coverage, cost share, and access/provider options.
    7. Identifyed any coverage restrictions and details on how to expedite patient access.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
Health Administration

Benefits Verification Specialist Resume

Headline : Defense contractor compliance consultant with experience providing support for a prominent management consulting firm with over 25,000 employees. Consulting areas include defense contractor compliance auditing, forecasting, strategic planning, training/development, data gathering/analysis, and organizational design/structure.

Skills : Customer Service, Administrative Assistant, Computer, Cashier.

Description :

    1. Collaborated with various Pharmacy Benefits Managers to retrieve processing information to process claims.
    2. Processed claims to ensure that the correct copays, deductibles and out of pockets are adhered to before medications are shipped.
    3. Submited for prior authorizations based on insurance plan specifications in a timely manner.
    4. Contributed to the company's success by exceeding performance objectives.
    5. Applied problem-solving abilities on a routine basis with limited supervision.
    6. Updated patient database with new insurance information.
    7. Knowledged of individual health plan insurances’ DME practices.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
Bachelor Of Arts