Insurance Verification Coordinator Resume Samples

Description :

1. Obtained drug donation through the hospital with the Director of Pharmacy.
2. Transferred patients onto hospice care within contract policy.
3. Performed site visits to hospitals instructing newly hired nurses on Chartwell's policy guideline for accepting new patients.
4. Trained new employees within Chartwell.
5. Assisted with the guidance of co-workers.
6. Assisted billing department in appealing denials from insurance companies.
7. Assisted Director of Nursing in collecting documentation for Medicare appeal hearings.

Experience

2-5 Years

Level

Junior

Education

Associate In Information Technology

Description :

1. Communicated effectively with patients, referring physicians, vendors, and all Radiologic associates in a civil and professional approach.
2. Completed verification of benefits for various health insurance companies.
3. Obtained pre-authorization for medical services when necessary.
4. Achieved accurate data entry skills, while utilizing a computerized healthcare system to insert medical information for each patient.
5. Utilized telephonic voice response systems and health insurance websites to obtain information on patient's eligibility status.
6. Contacted patients to obtain complete and accurate health insurance information; discuss eligibility outcome, and payment methods.
7. Secured precise and thorough documentation with the completion of all essential paperwork in a timely manner under the established guidelines.

Experience

2-5 Years

Level

Junior

Education

AA In Business Accounting

Description :

1. Called insurance carriers.
2. Accessed insurance carrier and/or affiliated websites.
3. Obtained eligibility and benefit breakdown.
4. Entered eligibility and benefit breakdown information into a central database and/or other locations.
5. Maintained performance.
6. Reported to Manager any issues, trends, and/or challenges associated with eligibility and/or benefit.
7. Interacted with fellow Eligibility and Benefits Team members in regards to best practices.

Experience

2-5 Years

Level

Junior

Education

Diploma

Description :

1. Called insurance companies to verify benefit coverage for DME.
2. Primary insurances and out-of-state coverage.
3. Initiated any prior approvals and authorizations needed.
4. Entered information into the system and recent dates.
5. Kept track of expired recent and requesting new auth.
6. Assisted billing with A/R reports with denials and reasoning.
7. Assisted discharge planners, social service workers, outreach organizations, and family.

Experience

7-10 Years

Level

Management

Education

Medical Office Administration

Description :

1. Verified all incoming discharge patient insurance & benefits for home health and or hospice.
2. Entered patient demographics into the McKesson database.
3. Scheduled appointments for home health & hospice.
4. Requested authorization from health plan/IPA.
5. Answered incoming calls from providers & patients.
6. Maintained a quota of authorization processes of 60 daily.
7. Trained new employees and created notes for a guide.

Experience

5-7 Years

Level

Executive

Education

Certificate In Medical

Description :

1. Correctly coded and billed medical claims for various hospital and nursing facilities.
2. Precisely completed appropriate claims paperwork, documentation, and system entry.
3. Thoroughly researched newly identified diagnoses and/or medical procedures to expand skills and knowledge.
4. Verified patients' eligibility and claims status with insurance agencies.
5. Collected insurance benefits information such as deductible, out-of-pocket maximums, co-insurance, and co-pays.
6. Verified coverage for specified CPT and ICD-9 codes.
7. Responsible for prior authorizations, denials, and appeal processes with varying insurance companies.

Experience

2-5 Years

Level

Junior

Education

Medical Assistant

Description :

1. Collaborated with two team members to re-structure the verifications department resulting in decreasing time from referral to verification of insurance coverage from +1 week to less than 24 hours.
2. Improved communications with clinicians and rebuilt the previously negative relationship resulting in a more effective working environment, quicker resolution of issues, and development of creative solutions to unique insurance problems.
3. Managed the insurance verification requests from 50+ clinicians for the delivery of Physical, Occupational, and Speech therapies to post-acute care settings in SNF, ALF, and NH facilities.
4. Maintained protected health information files for each patient, both electronically and hard copy.
5. Created reports at the request of management and executives reflecting benchmarks of time to verification, outstanding requests, and denied requests.
6. Traced trends and collaborated with colleagues to develop solutions to increase patient acceptance.
7. Obtained verbal and or written authorization for planned medical treatment from the appropriate sources.

Experience

10+ Years

Level

Senior

Education

Diploma

Description :

1. Identified and obtained any information regarding patients needing pre-certification, authorizations, or referrals by pulling reports from the HPF Webstation system and NextGen.
2. Verified Insurance for all scheduled procedures, inpatient admissions, and observation stays.
3. Communicated with Admissions, Utilization Review, Business Office, Physicians, or their offices regarding any problems or additional information needed for authorization, referral, or pre-certifications.
4. Utilized online verification and pre-certification systems.
5. Contributed to departmental and patient satisfaction.
6. Participated in department and hospital performance improvement plan.
7. Helped to ensure patient satisfaction, physician satisfaction, and effective revenue cycle process.

Experience

2-5 Years

Level

Junior

Education

Certificate In Medical Billing And Coding

Description :

1. Assisted in Patient Access DNB Discharge Not Billed Financial Clearing, experience in demographics, third party payor, Federal/State programs, commercial, and out of network.
2. Cleared high dollar and Inpatient and Outpatient accounts by updating information.
3. Followed up on pre-certifications on Inpatient Admissions.
4. Followed up on referrals on outpatient surgeries, radiology, procedures.
5. Assisted with outside groups from UCSD Medical Center such as clinical, hospital, physician's office.
6. Worked with the Inpatient Team when needed for authorization and referrals.
7. Experienced in Epic in patient access, Allscripts case management, IDX, Centricity Touch Works, Microsoft Office in excel, PowerPoint, and word.

Experience

5-7 Years

Level

Executive

Education

BS In Business Management

Description :

1. Performed verification on accounts received from registration interfaces, patient letters, and patient information forms.
2. Completed verification requests through contact with various insurance companies via phone, fax, and/or internet sources and makes changes as necessary.
3. Updated accounts with info and correct financial class if needed.
4. Created or updated patient accounts as well as registered patient visits.
5. Performed daily counts of incoming mail and manage a monthly count of what is received.
6. Operated systems: CB, children and university hospital epic, several insurance websites.
7. Verified insurance eligibility and benefits for patients.

Experience

2-5 Years

Level

Junior

Education

Diploma In Medical