Insurance Medical

OBJECTIVE

To obtain a position with a healthcare company that seeks an ambitious career oriented person and where acquired skills and training will be utilized toward growth and advancement.

EMPLOYMENT HISTORY

2012 - 2018 Insurance Verification Specialist

Digestive Care in Sunrise, Florida

Responsible for contacting insurance companies and navigating websites to obtain and inputs accurate information into the medical system.

Responsible for having working knowledge of payer eligibility and benefits verification.

Have complete understanding and working knowledge of navigating payer websites.

Responsible for obtaining authorization from insurance payers entering data in an accurate manner into the insurance patient, or hospital in order to resolve eligibility denials/rejections in a timely and accurate manner.

Responsible for submitting corrected claims to appropriate payers in a timely manner if needed.

Maintains and exceeds department standards for productivity and quality.

2006 - 2011 Medical Billing and Insurance Verification

Orthopedic & Sports Medicine Center, Newhall, California

Responsible for collection, billing, posting, and follow-up to Medicare, Workers Compensation, private and third party insurances.

Responsible for collection of outstanding balances from patients and insurance companies.

Responsible for maintaining accurate customer financial records.

Responsible for appealing insurance denials.

Negotiated patient payment plans.

Managed front office patient scheduling, insurance verification and authorizations.

Obtained medical authorizations for surgical procedures from private insurance companies as well as workers compensation.

2005- 2006 Billing and Coding Assistant

Paulina Perry CMC, Inc., Sylmar, California

Posting of patient charges and payments to MD Synergy system.

1996-2005 Assistant Manager

Maersk Sealand Company, Quito, Ecuador

EDUCATION

Medical Coding Seminar, Pierce College, Canoga Park, CA

Life & Disability Seminar, Lytespeed Learning Center, Encino, CA

Universidad Tecnologica Equinoccial, Quito, Ecuador

QUALIFICATIONS

Customer Service Representative

Medical Billing Forms

Insurance Verification/Eligibility

Knowledge of Clinical and Medical Terminology

Medical Records/Filling

Knowledge of HCFA and Medicare Regulations

Extensive knowledge finance/accounting/billing

Internet experience related to benefits and eligibility

Patient registration

Excellent communication skills (English and Spanish)

Dedicated, highly organized, detail oriented

Team player with a passion for helping others

Experience with MD Synergy Systems

Experience with e-Medsys Practice Manager

Experience with M/D Systems

Extensive CPT & ICD-9 experience

Microsoft Office Suite (Word, Excel, PowerPoint)

CERTIFICATIONS AND LICENSES

0440 – Customer Representative – Resident Insurance License

Insurance Collections & Patient Reimbursement – Certificate from National Provider Compliance Corp.

REFERENCES

Valerie Ashburn, Digestive Care, 954-***-****

Eileen Yates, Orthopedic & Sports Medicine, 661-***-****

Paulina Perry, 818-***-****

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