Insurance Verification Specialist Resume Samples

Description :

1. Answer telephones and direct calls to appropriate staff.
2. Schedule and confirm patient diagnostic appointments, surgeries, or medical consultations.
3. Greet visitors, ascertain purpose of visit, and direct them to appropriate staff.
4. Operate office equipment, such as voice mail messaging systems, and use word processing, spreadsheet, or other software applications to prepare reports, invoices, financial statements, letters, case histories, or medical records.
5. Interview patients to complete documents, case histories, or forms, such as intake or insurance forms.
6. Receive and route messages or documents, such as laboratory results, to appropriate staff.
7. Transmit correspondence or medical records by mail, e-mail, or fax.

Experience

2-5 Years

Level

Junior

Education

AAS In Liberal Arts

Description :

1. Verified patient eligibility and benefit package information via phone or online services for Family Practice and Cancer Therapy Research Center in advance for appointments.
2. Entered/updated demographics into Epic and IDX for new/established patient accounts.
3. Obtained insurance information necessary for various clinical services or procedures.
4. Obtained needed information from PCP and HMO payers' to initiate manage care authorizations allowing no more than 48 hours for completion.
5. Worked closely with clinic managers and/or designated person regarding issues with scheduling or insurance.
6. Advised supervisor of any pending or possible issues.
7. Accepted incoming calls from multi specialty clinics for verification purposes for walk-in patients utilizing Cisco Agent.

Experience

2-5 Years

Level

Junior

Education

Medical Assistant

Description :

1. Verify patients coverage for specific medical supplies.
2. Spend a lot of time on the phone with various insurance companies to see what coverage each individual has, whether supplies are covered or need authorizations.
3. Spend a great amount of time reaching out to dr's to obtain referrals, and request clinical documentaion.
4. Input accurate patient demographics and insurance information into patients files.
5. Input proper documentation and insurance notes into patients files.
6. Work medical supply orders in a timely manner.
7. Collect payments for patients who choose to pay for supplies when they are not covered.
8. Provide excellent customer service to our patients.

Experience

7-10 Years

Level

Senior

Education

Medical Assisting

Description :

1. Handle client/patient questions, complaints, requests or inquiries with the highest degree of courtesy & professionalism, with the goal of one-call resolution & patient retention.
2. Maintain a working knowledge of all CPAP products & services, as they may be required to work in one or more divisions or skill sets.
3. Conduct inbound and/or outbound calls to patients, doctors' offices, insurance companies as necessary or required to complete tasks.
4. Respond to telephone inquiries (inbound/outbound calls): ascertain patient needs; respond appropriately & with urgency to patient requests, questions, complaints & concerns.
5. Provide patients with accurate, timely, and satisfactory solutions to potential & arising complaints & concerns about their orders, devices, usage, and physician-ordered prescription(s).
6. Overcome objections & effectively resolve customer concerns with the goal of retaining patient accounts.
7. Receive & ensure appropriate processing of verbal & written/mailed orders.
   

Experience

2-5 Years

Level

Junior

Education

Business Administration

Description :

1. Completion of insurance verification on all scheduled outpatients.
2. Obtaining correct insurance information and benefits.
3. Maintain list of requirements from various insurance companies.
4. Obtaining authorizations on all inpatients.
5. Register sleep study patients Provide Outpatient Surgery Department with pre-registration paper-work.
6. Provide Outpatient Registration with daily surgery reports.
7. Patient Services Representative To ensure timely registration of all scheduled and non-scheduled patients.

Experience

7-10 Years

Level

Management

Education

Dental Assisting

Description :

1. Confer with customers by telephone or in person to provide information about products or services, take or enter orders, cancel accounts, or obtain details of complaints.
2. Keep records of customer interactions or transactions, recording details of inquiries, complaints, or comments as well as actions taken.
3. Review insurance policy terms to determine whether a particular loss is covered by insurance.
4. Determine charges for services requested, collect deposits or payments or arrange for billing.
5. Contact customers to respond to inquiries or to notify them of claim investigation results or any planned adjustments.
6. Resolve customers' service or billing complaints by performing activities such as exchanging merchandise, refunding money, or adjusting bills.
7. Recommend improvements in products, packaging, shipping, service, or billing methods and procedures to prevent future problems.
8. Lead a Team of 5 representatives in their daily functions.

Experience

7-10 Years

Level

Management

Education

High School Diploma

Description :

1. Gathered accurate and current insurance and demographic information to ensure clean billing status of patient encounter.
2. Called individual insurance carriers and utilizes online verifications services to verify benefits.
3. Entered all insurance and demographic information into system.
4. Answered all health center staff questions on insurance eligibility and benefits.
5. Ran patient schedule reports with scheduled intervals to ensure that benefit/eligibility problems can be identified and resolved with center before date of service.
6. Provided all information (i.e., co-payments, benefit limitations, deductibles, etc.) to locations in the form of "alert notes" via the computer system.
7. Obtained authorizations when necessary for procedures performed at the locations.

Experience

0-2 Years

Level

Entry Level

Education

Diploma In Phlebotomy

Description :

1. Verified patient insurances for radiological and surgical procedures.
2. Obtained information from major insurance companies on co-pays, deductibles, and co-insurance rates for surgical and non-surgical procedures.
3. Obtained and initiate medical authorizations for surgical and non-surgical procedures using CPT-4 and ICD-9 codes obtained from the physician's office's, payors, and other hospital and non- hospital personnel.
4. Discussed authorization issues with physician offices, payors, and hospital and non-hospital personnel.
5. Performed registration for inpatient, outpatient, and emergency room services.
6. Concierge reception for all patients that are visiting the Patient Access Department.
7. Verified and collected co-pays from patients in the emergency room and discussed the previous billing with patients.

Experience

0-2 Years

Level

Entry Level

Education

AA In General Studies

Description :

1. Proactive communication with clients, customers, and vendors via telephone, e-mail, or regular mail.
2. Verified patient insurance coverage, to ensure necessary procedures are covered.
3. Initiate prior authorization for durable medical equipment.
4. Communicate and educate patients, reps and MD office on coverge amounts provided by their insurance policy.
5. Maintain follow ups with patients, MD office, reps as well as insurance companies.
6. Educated in keeping patient accounts confidential with HIPPA regulations.
7. Established and maintained relationships through subcontracting adjusters as well as workers compensation.

Experience

5-7 Years

Level

Executive

Education

Diploma In Supervision

Description :

1. Provide customer service, such as limited instructions on proceeding with claims or referrals to auto repair facilities or local contractors.
2. Enter data, such as demographic characteristics, history and extent of disease, diagnostic procedures, or treatment into computer.
3. Review insurance policy to determine coverage.
4. Contact insured or other involved persons to obtain missing information.
5. Protect the security of medical records to ensure that confidentiality is maintained.
6. Review records for completeness, accuracy, and compliance with regulations.
7. Resolve or clarify codes or diagnoses with conflicting, missing, or unclear information by consulting with doctors or others or by participating in the coding team's regular meetings.
8. Compile and maintain patients' medical records to document condition and treatment and to provide data for research or cost control and care improvement efforts.

Experience

5-7 Years

Level

Consultant

Education

Accounting

Description :

1. Billed insurance claims Charge entry Handled receptionist duties on a multi-line switchboard.
2. Provided customer service support to the patients.
3. Performed administrative tasks that including scheduling and filing.
4. Served as accounts payable/accounts receivable as needed.
5. Performed supervisor duties when current supervisor was not available and/or absent.
6. Collected and entered payment into the office computer system.
7. Provided collection calls to insurance companies and patients when bills were outstanding.

Experience

10+ Years

Level

Senior

Education

HRM

Description :

1. Utilizes all available resources to obtain and enter insurance coverage information for services into patient's file.
2. Verifies patient insurance coverage of medications, administration supplies and related pharmacy services.
3. Facilitates and completes the prior authorization process with insurance companies and practitioner offices.
4. Completes a full medical verification for all medications.
5. Notifies patients, physicians, practitioners and/or clinics of any financial responsibility of services provided and requested services not provided by the facility.
6. Provides notification of urgent orders to the senior level or group supervisor and communicates with other departments when an urgent need for filling a prescription or delivery is necessary.
7. Places outbound calls to patients or physician offices to obtain additional information.
8. Manages inbound calls on the insurance line from patients, clients, & physicians regarding inquiries about services provided, financial responsibility and insurance coverage.

Experience

0-2 Years

Level

Entry Level

Education

General