Insurance Medical
Resume:
Barbara Rush
***** ****** ******** *****, *******, TX 77433 * 713-***-**** * ********@*****.***
OBJECTIVE:
My objective is to work in a long-term, permanent position that magnifies my talents in the medical field and aid in my long-term professional growth; finding an organization that promotes professional development and career advancement will assist in further developing my skills and education.
EDUCATION:
Management Information System & Computer Service: Houston Community College, 1987 – 1992
High School Diploma, Willowridge High School, Graduated May 1986
PROFICIENCIES:
20 years of administrative, customer support, conflict resolution, training and medical experience.
Efficient in medical benefits, billing, data-entry, audits, scheduling, coaching, and administrative tasks.
Exceptional relationship building with new and existing clients.
Stellar inter-department communications.
Consistently takes initiative and is known as a “go-getter”.
Detail-oriented team player that is admired by colleagues.
Technical Skills: Type 35 - 45 words per minute, 10-key, MS Outlook, Word, Excel, Centricity, Citrix, Salesforce and Bright Tree.
WORK EXPERIENCE:
Insurance Verifier, Billing & Coding (Durable Medical Equipment), Refund Coordinator Specialist and Trainer
Global Sleep – Houston, TX 12/2011 – 05/2017
Performs telephonic support for online authorization of routine services.
Provides direct support to Primary Care practices and specialty care providers regarding utilization, authorization, and referral activities.
Proficient in the use of ICD-10 and CPT codes.
Data entry referrals for non-complex services including inpatient and outpatient care.
Provides data entry for care which has been arranged.
Contacts providers with authorization, denial, and appeals process information.
Assists in educating and acts as a resource to primary care practices and specialty care providers.
Determines member benefit coverages.
Works closely with all departments to obtain proper approvals for each refund being ordered.
Researches and audits refund amount being requested and rejects any refund requests not in compliance with company’s policies and procedures.
Processes and approves final adjustments.
Full control and knowledge of current refund policies and regulations.
Responsible for processing patient data, treatment records and related insurance information.
Processes billing codes in accordance with patient’s diagnosis along with request for payments from insurance companies.
Trains all new employees and coaches them throughout periodically.
Performs other duties as needed.
Medical Receptionist
Memorial Cardiology – Houston, TX 08/2005 – 12/2011
Welcomed and greeted all patients and visitors, in person and over the phones.
Answered the phone while maintaining a polite, consistent phone manner using proper telephone etiquette.
Responsible for keeping the reception area clean and organized.
Registered new patients and updated existing patient demographics by collecting detailed patient information including personal and financial information.
Facilitated patient flow by notifying the provider of patients’ arrival, being aware of delays and communicating with patients and clinical staff.
Responded to patients’, prospective patients’ and visitors’ inquiries in a courteous manner.
Documented medical insurance information, verified medical benefits, handled medical insurance co-payments and processed medical insurance submissions.
Kept medical office supplies adequately stocked by anticipating inventory needs, placed orders and monitored office equipment.
Protected patient confidentiality by making sure protected health information and insurance is secured.
Performed other duties as needed.
Front Office Coordinator
Pain & Health Management – Houston, TX 02/2000 – 07/2005
Welcomed and greeted all patients and visitors, in person and over the phones.
Answered the phone while maintaining a polite, consistent phone manner using proper telephone etiquette.
Responsible for keeping the reception area clean and organized.
Registered new patients and updated existing patient demographics by collecting detailed patient information including personal and financial information.
Facilitated patient flow by notifying the provider of patients’ arrival, being aware of delays and communicating with patients and clinical staff.
Responded to patients’, prospective patients’ and visitors’ inquiries in a courteous manner.
Documented medical insurance information, verified medical benefits, handled medical insurance co-payments and processed medical insurance submissions.
Kept medical office supplies adequately stocked by anticipating inventory needs, placed orders and monitored office equipment.
Protected patient confidentiality by making sure protected health information and insurance is secured.
Performed other duties as needed.
Administrative Assistant
Cam Concrete Construction, Inc. – Houston, TX 11/1997 – 02/2000
Answered, screened and transferred inbound phone calls.
Received and directed visitors and clients.
General clerical duties including photocopying, faxing, electronic and paper filing and mailing.
Handled requests for information, accounts payable and data-entry.
Resolved administrative problems and inquiries.
Prepared and modified documents including correspondence, reports, drafts, memos and emails.
Scheduled and coordinated meetings, appointments and travel arrangements for management team.
Prepared agendas for meetings and daily schedules.
Recorded, compiled, transcribed and distributed minutes of meetings.
Opened, sorted and distributed incoming correspondence.
Maintained office supply inventory and office equipment maintenance.
Performed other duties as needed.
Medical Receptionist
MacGregor Medical Association – Houston, TX 01/1993 – 11/1997
Welcomed and greeted all patients and visitors, in person and over the phones.
Answered the phone while maintaining a polite, consistent phone manner using proper telephone etiquette.
Responsible for keeping the reception area clean and organized.
Registered new patients and updated existing patient demographics by collecting detailed patient information including personal and financial information.
Facilitated patient flow by notifying the provider of patients’ arrival, being aware of delays and communicating with patients and clinical staff.
Responded to patients’, prospective patients’ and visitors’ inquiries in a courteous manner.
Documented medical insurance information, verified medical benefits, handled medical insurance co-payments and processed medical insurance submissions.
Kept medical office supplies adequately stocked by anticipating inventory needs, placed orders and monitored office equipment.
Protected patient confidentiality by making sure protected health information and insurance is secured.
Performed other duties as needed.
Customer Service Representative
Eco Resources, Inc. – Houston, TX 01/1992 – 01/1993
Conferred with customers by telephone or in person in order to provide information about products and services.
Took orders and canceled accounts.
Obtained details of complaints and escalated where appropriate.
Kept records of customer interactions and transactions.
Resolved customer complaints within company guidelines.
Handled all data-entry requests efficiently and effectively.
Performed other duties as needed.
ADDITIONAL TRAINING AND CERTIFICATIONS:
Course: Using Microsoft Excel – Level 1, 09/2015, 12/2013
Course: Patient Rights and HIPAA Privacy Regulations, 05/2015, 01/2014, 04/2013, 01/2012
Course: Error-Prone Medical Terminology, 05/2015
Course: Regulatory Agencies – FDA, 08/2014
Course: Leadership and Lines of Authority, 08/2014
Course: Internal and External Audits, 12/2013
Course: Managing Your Time, 12/2013
Course: Running a Successful AR Department, 12/2013
Course: CPAP/Bi-Level Units & Coverage, 12/2013
Course: Performance Improvement, 08/2013
Course: Using Microsoft Word – Level 1, 09/2012
Course: Introduction to Credit and Collections, 08/2012
Course: Credit and Collection Techniques, 08/2012
Course: Reimbursement Management, 04/2012
Course: Claim Payment and Cash Receipts, 04/2012
Course: ICD-9-CM Coding Guidelines, 02/2012
Course: Medicare and You, 01/2012
Course: National Provider Identification (NPI), 01/2012
Course: Email Etiquette, 01/2012
REFERENCES:
Available upon request
Contact this candidate