Insurance Verification Representative Resume Samples

Insurance companies hire the Insurance Verification Representative for processing insurance claims. The major roles and responsibilities listed on the Insurance Verification Representative Resume include but are not limited to the following – checking the information provided in the insurance forms, overseeing insurance claims reimbursements, performing data entry tasks, approving or denying processing, completing medical screening and patient payment estimates, entering document details in applicable systems, and obtaining prior authorization for procedures.

Eligible candidates for this role must depict on the resume these skills – a strong understanding of benefits investigating, deductibles and co-insurance; ability to handle multiple responsibilities, knowledge of medical terminologies, intermediate experience in MS Office and insurance claims expertise. Successful resumes for this post make a display of an associate’s degree or bachelor’s degree in economics, business administration or finance. Work experience is not mandatory as eligible candidates are provided on-the-job training.

Insurance Verification Representative Resume example

Senior Insurance Verification Representative Resume

Summary : An ambitious, self-motivated and extremely hard worker. An excellent team player. To utilize the opportunity given and to serve to achieve the best on behalf of the organization by enhancing the skills and abilities. To work in a progressive environment, which fosters individual and organizational growth.

Skills : Team Work, MS Word, Outlook, PowerPoint, Strong Organizational skills

Description :

    1. Enter data in an accurate manner to update patient benefit information in Epic.
    2. Confer with patients to let them know their financial obligation once coverage is verified.
    3. Provide patients pertinent information regarding their coverage to explain coverage amounts provided by their insurance policy, so they can understand why some procedures may be covered, while others are not.
    4. Verify that existing information is accurate.
    5. Communicate with insurance companies via telephone or their website.
    6. Perform light administrative duties, such as faxing and scanning, as needed.
    7. Verify Medicare and Medicaid eligibility for patients who qualify.
    8. Obtain pre-certification and referrals for upcoming appointments.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Senior
Education
Education
Bachelors Of Science


Insurance Verification Representative I Resume

Summary : Focused and results-driven Insurance Verification Representative I with 12 years of dedicated experience and exposure medical industry. A proven notable asset in work performance of accuracy, time management, and leadership. Highly qualified in reviewing, analyzing and interpreting health benefits and filing liability account liens.

Skills : Microsoft Office, Insurance Verification, Document Management, Document Control, Account Management, Medical Terminology

Description :

    1. Deliver excellent communication with customers to ensure productive resolution.
    2. Verify patient health benefits via telephone or online resources.
    3. Accurately data enter health benefits in the hospital system.
    4. Efficiently provide additional research as needed to the hospital and management for the accounts further development.
    5. Strong team player, initiate assisting others as needed.  Completed PASI Leadership Development Program.
    6. Recognized for assisting with special department projects, acquiring 50% of the created and implemented policy.
    7. Advise the development of strategies to improve the quality of work performance; set up a system to maintain accurate and timely workflow.
Years of Experience
Experience
10+ Years
Experience Level
Level
Management
Education
Education
Bachelor Of Science


Junior Insurance Verification Representative Resume

Objective : Talented, results-producing Junior Insurance Verification Representative with a proven record of accomplishment in medical billing, customer service oriented positions with expertise including insurance verification, administrative skills, project management, human relations, and much more.

Skills : Medical Terminology, Process Improvement, Performance Management, Leadership Development.

Description :

    1. Pre-screen accounts for a possible third-party payer.
    2. Responsible for the billing and follow-up of insurance accounts.
    3. Contacts third-party payers via telephone/mail for payment status, according to the schedule of disposition to be worked on given days.
    4. Researches identify and rectify any special circumstances affecting delayed payment on accounts to include appeals of denied claims.
    5. Writes up payments and adjustments for posting to the FACS system.
    6. Verifies any balance after insurance has paid is the patient's responsibility before transferring the account to self-pay.
    7. Documents activity in the patient accounting system.
    8. Maintains all reports, files, and records as needed.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
Bachelor Of Science

Insurance Verification Representative - Temp Resume

Headline : Independent and self-motivated to excel and emerge in leadership to contribute growth and success in the organization. To work in a dynamic professional organization with full dedication and spirit to create synergies and to embark upon a career that provides an opportunity to develop and enhance the skills.

Skills : Customer Service, Data Entry, Employee Relations, Strategic Planning

Description :

    1. Verified insurance plans on a patient account prior to medical services.
    2. Add new insurance plan information to appropriate patient accounts.
    3. Terminated expired insurance plans which were being billed incorrectly.
    4. Notified the appropriate department via email regarding an expired insurance plan which was billed at guarantor level.
    5. Called patients to obtain up-to-date insurance coverage and making corrections or additions in the system.
    6. Obtain an accurate daily work list and maintain daily/monthly production standards.
    7. Provide support to fellow coworkers to help meet our weekly departmental goals.
    8. Making sure all necessary paperwork is attached to order for processing and verification.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
High School Diploma

Associate Insurance Verification Representative Resume

Objective : To achieve a distinguish place in a dynamic environment that besides offering a job, would also provide opportunities for growth where one can prove their optimum potential, expand the professional horizon and grow along with the organization.

Skills : Medical manager, MS word, Excel, Powerpoint, Outlook, IDX, Citrix, Med Assets, Emdeon, UGS, LLEAP.

Description :

    1. Responsible for verifying eligibility and benefits for patients at multiple Commonwealth Health facilities.
    2. Communicating with those facilities to share information as needed, following HIPAA guidelines at all times during communications involving patient information.
    3. Contacting insurance companies to obtain accurate allowance and limit information on certain services.
    4. Contacting patients to pre-register for upcoming procedures and verify demographics.
    5. Collect on any monies due at the time of service or on past accounts.
    6. Assist with creating training documentation for potential new hires within the company.
    7. Provide training to new hires regarding HIPAA procedures.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
Bachelor Of Science

Insurance Verification Representative - Part Time Resume

Headline : To work in an environment that offers challenging opportunities and demands more of the services, utilize the skills to contribute to the growth of the company and in turn, enhance the knowledge and personal growth. To work for an organization that provides the opportunity to improve the skills and knowledge to growth along with the organization's objective.

Skills : Customer Service, Team Player, Microsoft Office

Description :

    1. Verified benefit information for all insurances including; all branches of BlueCross BlueShield, Medicaid MCO's, Kaiser Permanente, Cigna, Aetna, Medicare, and Medicare Advantage Plans.
    2. Utilized insurance websites to process authorizations for outpatient services.
    3. Faxed all necessary clinical notes to the correct insurance for authorization approval.
    4. Managed work queues and utilized reports to process accounts.
    5. Called patients to pre-register prior to their scheduled appointment.
    6. Received calls to pre-register patients for surgery and labor and delivery.
    7. Utilized ICD-9 and CPT codes to complete authorizations for proper billing.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
Bachelor's In Psychology

Lead Insurance Verification Representative Resume

Summary : Proficient, Lead Insurance Verification Representative, seeking a fulltime position, to utilize the skills, knowledge, and experience to deliver and ensure efficient results with-in the organization. Ability to learn quickly, provide cooperative team leadership, maintain self-motivation, and work independently under pressure and deadlines.

Skills : Microsoft Word, Outlook, Various phone systems, Typing, Filing including electronic filing.

Description :

    1. Verified all insurance coverage. Posted all co-pays and patient payments accounts.
    2. Evaluated uncollected accounts and recommend referral to outside collection agencies.
    3. Performed all routine and special follow-up on all assigned accounts.
    4. Maintained routine communication with physicians, and staff to effectively handle account balances.
    5. Negotiated credit extensions when necessary for patients.
    6. performed various administrative functions for assigned accounts, including purging the records of deceased customers.
    7. Arranged for debt repayment and established repayment schedules as well as handle delinquent accounts.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Senior
Education
Education
Associates

Insurance Verification Representative - Intern Resume

Objective : Highly organized Insurance Verification Representative efficient in working on claim processing & Reconciliation processing, end to end Payment issues, handling customer and client, refunds escalations, query management, banking activities, mentoring, auditing, etc. To gain experience in the field utilize the skills, in order to increase the productivity of the organization and individual growth.

Skills : Excel, Powerpoint, Data Entry, Spreadsheets, Epic, Microsoft Word.

Description :

    1. Verified insurance coverage for order processing of durable medical equipment.
    2. Communicated with insurance companies and underwriters to obtain accurate insurance coverage.
    3. Worked closely with the claim and collection representatives to ensure clean claim rates.
    4. Followed proper HIPAA protocols to ensure patient confidentiality.
    5. Provided accurate and appropriate information in response to customer inquiries.
    6. Reviewed data to verify the validity of claims. Explained EOBs to policyholders, agents, and underwriters.
    7. Ensures accurate and timely data entry into the RIS system for each patient, according to established standards.
Years of Experience
Experience
0-2 Years
Experience Level
Level
Entry Level
Education
Education
Bachelor Of Science

Insurance Verification Representative - Full Time Resume

Summary : To join a dynamic company who focuses on world class customer service, forward thinking and actively engaging in change for the betterment of the bottom line, client satisfaction and employee retention. A company who values their associates, rewards results and has a vibrant work environment.

Skills : Medical manager, MS word, Excel, Powerpoint, Outlook, IDX, Citrix, Med Assets

Description :

    1. Completes insurance verification process on initial orders.
    2. Completes insurance re-verification process via multiple company systems and application.
    3. Contacts numerous insurance companies to determine DME, major medical, and prescription card.
    4. Obtained benefits from companies such as Humana, Aetna, Blue Cross Blue Shield, etc.
    5. Utilizes multiple programs available as a reference or guide to accomplishing goals efficiently.
    6. Accurately documents insurance information.
    7. Documents prioritize and organizes incoming tasks and workflow.
    8. Review insurance coverage to determine order eligibility.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Senior
Education
Education
Diploma

Insurance Verification Representative - Contract Resume

Summary : Motivated, personable Insurance Verification Representative, flexible and versatile - able to maintain a sense of humor under pressure. Poised and competent with demonstrated ability to easily transcend cultural differences. Thrive in deadline-driven environments. Excellent team-building skills and exceptional customer service.

Skills : Microsoft Word, Outlook, Various phone systems, Typing, Filing including electronic filing.

Description :

    1. Verifying insurance for durable medical equipment Processing orders for patients, hospitals and doctors' offices.
    2. Following up with Doctors' offices for needed information.
    3. Researching the patient's account for previous items purchased and for supplies needed.
    4. Reading the doctor's prescription and looking up ICD9 codes for doctor's diagnosis.
    5. Following up with patients after equipment and supplies have been delivered.
    6. Working closely with all insurances Following Medicare guidelines when processing all Insurances.
    7. Making sure all necessary paperwork is attached to order for processing and verification.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Senior
Education
Education
Certificate

Insurance Verification Representative Resume

Headline : Dedicated Insurance Verification Representative with 5+ years providing outstanding support and knowledge in medical billing and office administration. Currently looking for a full time or part-time position in medical billing, front desk reception or customer relations.

Skills : Customer Service, Insurance Verification, Windows, Computer Skills, Referrals.

Description :

    1. Verification of eligibility of members and participating status of providers.
    2. Determine member benefit coverage, coinsurance, deductibles, and co-pays.
    3. Call patients to obtain insurance information. Direct support to Pain Management clinic for bilingual translation.
    4. Assistance to other customer service reps for Spanish speaking patients.
    5. Obtain authorizations for specialty office visits. Contact providers with authorization or denials.
    6. Familiar with Vision, Athena, Ingenious Med, Compass, Interactive Dash software.
    7. Works with patients to obtain complete and correct insurance information, discusses eligibility results and alternative payment methods.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
Associates