An Insurance Specialist is a specialized professional who will interpret insurance policies and determine the exact coverage amount. Working in a variety of setting including medical and government offices, laboratories and hospitals, these specialists will carry out all duties that are listed on the Insurance Specialist Resume – deciphering complicated insurance laws and policies; ensuring the government programs comply with federal laws and regulations; advising on eligibility and coverage issues; dealing with health insurance billing and payments and keeping track of patients records for processing claims and billing codes.
Whatever may be work setting, the applicants should demonstrate the following skills – good understanding of federal laws and regulations governing government programs such as Medicare and Medicaid; familiarity with various eligibility and coverage concepts; and experience in medical insurance billing and coding. Graduates with specialized training in the field have a better chance of getting placed.
Summary : Dynamic Certified Professional Coder seeking a position to utilize skills for the benefit of your company, as the providers provide quality healthcare to patients.
Skills : Microsoft office, Microsoft Excel, Officemate, ICD 9, ICD 10, Medical terminology, 10 key calculator.
Ensures accurate insurance benefit determinations through active investigation.
Consistently initiates pre-certification when required and notifies the Financial Counselor when coverage issues arise.
Positive, effective communications with interrelated areas assuring prompt follow up and courteous reception.
Maintains quality performance and productivity standards.
Positive, well-organized and capable of motivating others to positive outcomes.
Verify accounts for accuracy to ensure that the correct codes are entered to avoid and reduce claim denials.
Patient Accounts Specialist IV Responsible for collecting co-pays, ensure claims are processed timely, register patients, verify insurance, investigate claims and problem solve, float from various departments, post charges, interact with internal and external customers.
Auto Insurance Specialist Resume
Summary : Working with a company dedicated to helping individuals or companies identifying opportunities and promoting new markets utilizing a unique set of skills centered on problem solving, explaining processes and alternative solutions. I have also led teams to exceed sales expectations focusing on positive outcomes in every opportunity.
Skills : Successful Leader With Start Up And Fortune 500 Experience.
Perform insurance deduction activities for personnel and reconcile data printouts.
Coordinate personnel actions with payroll deductions and data processing for insurance deductions.
Compile data and prepare various reports relative to insurance benefits.
Receive, screen and direct incoming telephone calls and walk-ins; answer questions regarding benefit coverage, costs and payroll information as necessary.
Update and maintain employee files regarding changes in benefits and employment as necessary.
Maintain and process various insurance billings and distribute insurance materials to staff and department supervisors.
Maintain and update payroll files and records of a confidential nature with insurance emphasis, COBRA, TEFRA and leaves of absences.
Process and maintain records of staff leaves and absences.
BS In Business Administration
Military Service Insurance Specialist Resume
Objective : Insurance Verification Specialist seeking position in which my training and experiences can help increase the client base and growth of the company.
Utilized presentation software and incorporated Power Point presentations.
Developed training manuals, presentations and videos on numerous topics.
Designed and conducted surveys of instructors, managers and participants.
Researched best practices and used them in all training programs.
Aligned new learning development and solutions with the company's strategic goals.
Responsible for corporate and consumer sales and account management.
Bachelor Of Arts
Insurance Specialist/Insurance Agent Resume
Summary : To find a challenging position within a growing company where I can utilize my previous work experience as well as my education.
Skills : I'm great with people and interacting with them. I'm familiar with computers and computer programs such as Microsoft Word, Excel and Publisher. I also have some experience with customer service.
Audited hearing aid claims for quality and accuracy prior to submission.
Reviewed and handled claim rejections in Healthfusion from payer rejections to claim submission errors, as well as audited transmissions to ensure claims had been received by payer.
Provided claim report analysis researching billing issues, and escalated billing issue resolution and patient account accuracy.
Served as a liaison for all communication with the Sonus and Miracle Ear corporate and franchise clinic staff and franchise owners.
Conducted quality reviews of billing staff daily work.
Utilized operation tools to provide leadership that ensured growth and development.
Developed, designed, and implemented department policies and procedures.
Provided reimbursement analysis for codes and procedures company was billing for.
Objective : Associate professional with broad experience in both Sales and Customer Service Industry, with strengths in organizing and work processes, retention and building and maintaining strong relationships with our internal customers. Experiences that implement new service product. Proven ability to implement effective policies and procedures, to enhance productivity results, and increase process efficiencies.
Skills : Excellent communication, negotiation, and mathematical skills, as well as attention to detail.
Provided quotes for home and auto, personal and commercial, insurance from a variety companies to best suit the customer's needs.
Prepared bank deposit and controlled cash box.
Processed payments, analyzed, evaluated, and managed changes to existing policies and maintained verbal and written correspondence with clientele and represented insurance companies.
Maintained and organized the physical and electronic files.
Trained staff on specialized company databases used to hold active or recently active policies and on the company software used for quoting a client's insurance costs.
Completed software updates and database back up.
Worked with database designer to troubleshoot and implement corrective procedures required to support the working process and improve efficiency.
Bachelor's In Computer Science
Medical Biller/Insurance Specialist Resume
Objective : Administrative Assistant -specializing in administrative support to busy medical office. Committed to delivering high quality results with little supervision. Highlights Microsoft Office proficiency Understands grammar Excel spreadsheets AR/AP Meticulous attention to detail Medical terminology Results-oriented Mail management Self-directed Meeting planning Time management Insurance eligibility verifications Professional and mature Dedicated team player Strong problem solver.
Skills : Excel, Microsoft Office Suite, Outlook, Access, And Power Point.
Procure and disburse homeowner's, flood, wind and optional insurance renewals, with an average number of disbursements per day of 10-15.
Research discrepancies with insurance bills to maintain consistency of system information.
Research and resolve unmatched disbursements that are rejected by the system for payment.
Monitor insurance expiration reports and follow up on any missing bills.
Review and process insurance losses from member, According to company guidelines Process requests from members or credit unions to drop private mortgage insurance coverage.
Track loans with force placed insurance coverage.
Process incoming tasks from the Member Service Department, Follow up on premiums to be paid to insurance companies, also questions related to Private Mortgage Insurance,(PMI), determining if it was still required on the mortgage.
Research and resolve Flood insurance requirement issues.
Reinsurance Specialist Resume
Summary : I am driven to succeed in everything I do. I deliver positive experiences through high-quality of work flow and customer care. I am proficient in data entry and I am working on my Medical Coding and Billing Degree.
Skills : <div>Data Analysis, Ensure Compliance, Surety, Special Projects.</div>
Purchased all equipment, supplies and services for the college, from qualified vendors and according to applicable purchasing laws.
Edited and processed incoming purchase orders.
Organized the bidding process in accordance with state purchasing laws.
Helped prepare specifications, advertised for bids, arranged pre-bid conferences, bid openings and prepared bids for Board approval.
Coordinated interior design of College facilities, such as furniture purchases for offices, meeting rooms, and classrooms, carpet and window treatment selections, and paint color choices; and consulted with vendors.
Completed various insurance renewal processes; maintained files for general insurance coverages and claims and contacted insurance broker regarding claims and inquiries.
Coordinated special events such as annual Black History Month celebration and Support Staff United Way Silent Auction.
Served on various internal committees such as Cabinet, Strategic Planning and Policy Committee.
Transportation Insurance Specialist Resume
Objective : I have worked in daycare for 3 years as a 3-4 year old teacher also did deposits and some scheduling. Then I became a nanny for 2 foster children where I would care for their everyday needs, for 3 to 5 years. Then Winchester Ped. Clinic where I have been for 12 years where I greet patients and make appointments. Also I have worked check in and check out now I am in Insurance where I post checks to patients account, call insurance company when there needs to be a change or adjustment.
Skills : Billing and Coding.
Managed high call volume with tact and professionalism.
Prepared reports and communication for senior management and clients.
Referred unresolved customer grievances to designated departments for further investigation.
Prepared reports and communication for senior management and clients.
Managed high call volume with tact and professionalism.
Acted professionally and patiently when addressing negative customer feedback.
Modeled exceptional customer service skills and appropriate diagnostic sales techniques.
Bachelor Of Science
Business Insurance Specialist Resume
Objective : I am seeking a position with a company that will further enhance and cultivate my development in the health care field. As a health care professional, I would like to work in support and favor of the esteemed organization I would be working for. I would be devoting my time and extra effort to work for the advancement and progress of the organization. With my good interpersonal and communication skills, I will have confident and assured talks with the individuals at all levels.
Skills : Patient care, Vitals, Injections, blood work, EKG, kept rooms equipped and sanitized.
Managed all release of information processing recipient health information case files to perform data analysis and profiling to determine recovery opportunities from fraudulent, abusive or erroneous claim payment and reported activities.
Extract and analyze data for data modeling and the development of detailed metrics.
Build and maintain a database, electronic spreadsheets, data analysis, metrics and management reports primarily through Excel, Access and SQL.
Initiate accurate records and maintain records in a confidential, secure, complete, and accessible manner for future recipient oversight.
Coordination of record delivery, contracting multiple coordination of record and billing department requests.
Retrieve, collate, assemble, deliver, scan and file medical records in accordance with established policy.
Responsible for reporting of all release of information processing, per policy.
Health Insurance Specialist Resume
Objective : Motivated and hardworking professional who accurately reviews insurance accounts receivable for assigned clients for the purpose of identifying and taking the steps needed to ensure prompt claims adjudication, until claims are either paid or denied.
Skills : Microsoft office, Excel, Meditech, SMS, Cerner, Advantx.
Review insurance accounts to determine the action steps needed to expedite claims payment and/or monitor claims until paid or denied.
Perform necessary insurance follow-up actions to ensure prompt and accurate account resolution; assign accounts to the correct disposition based upon status.
Document conversations with responsible parties regarding accounts on both the company and client systems.
Utilize automated claims verification systems via phone or online systems.
Respond to incoming phone calls and email inquiries regarding patient/client accounts.
Professionally represent myself and the assigned client when interacting with the client, staff, patients, and guarantors.
Appropriately bill claims and post necessary insurance adjustments to accounts on client system.
Assist management staff in compiling and analyzing productivity data.
Associate In Arts In Pre
Medical Insurance Specialist Resume
Summary : I have multiple years experience as a professional medical biller. I have recently started to work on the ICD-10 transition with cloud computing.
Skills : EMR Software Thru Eclinicalworks.com.
Responsible for training employees about current managed care and insurance updates.
Assist Spanish speaking patients with appointments, billing questions and translate for medical personnel.
Audit electronic claims thru the EDI system.
Using the E-clinical works software posted daily insurance payments utilizing Electronic Remittance Advice and manually posting of checks.
Reconcile insurance payments to explanation of medical benefits.
Appealed denied or suspended medical claims.
Responsible for the audit of patient and insurance refunds using the excel spreadsheet.
Health Insurance Specialist Resume
Objective : Dental professional with vast knowledge of clinical procedures and medical and dental terminology. Periodontics, Endodontics and Cosmetic Dentistry expert. facility.
Skills : Mainframe, NOC, MS Office, Ms Word, Ms Excel, Training, Supervisor, Printers, Troubleshooting, Personnel Management, Server, Network Administration.
Greeted and prepared patients for dental examinations.
Coordinated appointment schedules for the dentist.
Reviewed status of waiting room on a routine basis to ensure that patients were being seen in a timely fashion.
Provided appropriate postoperative instructions as prescribed by dentist.
Thoroughly gathered and recorded medical and dental histories and vital signs of patients.
Expertly filed patients' charts and processed billing and payments.
Managed invoices and transaction receipts.
Accurately collected and recorded patient medical and dental histories.
Associate Of Applied Science
Life Insurance Specialist Resume
Objective : Effectively utilize my managerial skills to manage a company risks in Worker Compensation, ADA, Leave of Absences programs and other property & casualty insurance products which will assist in the achievement of a company's financial target.
Skills : Insurance Claims.
Print and review invoices for accuracy according to company standards, department processes and insurance guidelines.
Enter appropriate and necessary information into the claims filing software in order to prepare required claims to be sent electronically.
Review customer accounts/patient accounts receivables/aging and take necessary steps to keep accounts current.
Contact insurance companies, obtain necessary documentation for insurance requests and request refunds and write offs as necessary.
Answerer incoming calls from patient sand clinicians about reimbursement, processes.
Maintain current files and billing records make changes as needed so patient information is accurate and complete.
Experience in, Medicare re-openings, re-determinations and appeals.
Medical Billing Course
Hazard Insurance Specialist Resume
Objective : To obtain a position that will enable me to utilize and expand my analytical skills and professional experience.
Skills : Certified expert in Microsoft Word, Excel, and Access.
Reviewed and maintained the current status of all managed care and commercial insurance.
Re-billed claims with corrections and modifications to ensure reimbursement.
Obtained the necessary information to correct and process denied claims.
Noted all transactions and changes in patient demographic and patient notes for future claims.
Reviewed aging report daily to ensure all individual rejections were worked before timely filing issue arises.
Communicated coordination of benefits changes with other departments, as well as noting patient accounts.
Informed team lead or supervisor on any account problems and the resolution to solve problems.
Performed all duties in a professional and curious matter.
Certificate In USA Army
Insurance Specialist Resume
Objective : Diligent, detail-oriented person seeking employment in established company with growth and development opportunities, bringing the following experience, attributes, and skills: Knowledgeable in all office functions. Proficient in Microsoft Office, Excel, PowerPoint, and Outlook. Excellent customer service skills. Outstanding team player with good interpersonal communication. Ability to work independently and manage time efficiently.
Skills : Microsoft Office Suite, Microsoft Outlook, Multi-Tasking,.
Medical coding and insurance billing of charges.
Followed up on outstanding medical claims.
Went over daily reports to insure electronic claims had been sent and would troubleshoot any errors that have occurred.
Posted insurance remits to correct outstanding accounts.
Worked one on one with patients with financial shortcomings in order to come to a payment arrangement beneficial to both the patient and the practice.
Spoke with patients regarding questions about accounts and insurance related inquiries.
Managed schedule for six doctors and one nurse practitioner.
Worked closely with front office staff in order to keep schedule running smoothly.