Insurance Management
Resume:
*********@*****.***
To Whom It May Concern:
I am permanently relocating to Texas this June as my husband has accepted a job offer in the area. My family and I are extremely excited for this next journey in our lives and awesome opportunity to officially become a “TEXAN.” I am extremely interested in obtaining a position with your company. I have outlined some information about myself below and attached a copy of my resume for your consideration throughout my career I have been known as a quick learner, self-starter and a dedicated worker. I have demonstrated my ability to handle a variety of tasks effectively and deliver on deadlines. Although I work well independently, I am equally comfortable working as part of a team. I enjoy interacting with customers/patients and taking pride in excellent customer/patient service.
I have demonstrated excellent abilities to all my past endeavors. The dynamic atmosphere that prevails in your company is very much in tune with the atmosphere that I have always worked best in. I know that my knowledge and passion for this field will enhance the customer’s/patient relationships that are so fundamental to your company’s success. I am a reliable and results oriented professional, experienced in mechanical operations, who exhibits significant leadership skills dedication to teamwork and a strong work ethic.
I am accustomed to a fast paced environment where deadlines are priority, handling multiple jobs is the norm, and the only thing constant is change. I thrive on challenge and feel my skills and experiences are easily transferrable. I would like to thank you in advance for your time and consideration. I look forward to hearing from you. I also welcome the opportunity to discuss my qualifications. You may contact me at 630.723.918.
Warm Regards,
NINA SWIRE
*********@*****.***
NINA SWIRE
OBJECTIVE
Highly-motivated and performance driven healthcare professional with strengths in healthcare insurance and revenue cycle. Experienced user of Epic Hospital Billing, and multiple claims clearinghouse systems. A people-person with the ability to develop collaborative business relationships due to strengths in interpersonal and written communication skills required to effectively meet organization or department goals.
SKILLS & ABILITIES
EHR/EMR HIPPA CITRIX EPIC SYSTEMS MEDISOFT ORACLE AFFINITY
ORACLE OCCUSOURCE PHS/HPF AFFINITY PASSPORT ZIRMED MYSIS
PATIENT ACCOUNTING WORKER’S COMPENSATION STAFF TRAINING
MEDICARE&MEDICAID COMMERCIAL INSURANCES & MANAGED CARE REQUIREMENTS
MICOSOFT OFFICE SUITE TYPE 65WPM
EXPERIENCE
AUTHORIZATIONS & BENEFIT SPECIALIST, CONNECT HEARING INC. 07/14 - PRESENT
Assist with special projects assigned by management as needed. Identify trending issues and provide suggestions for resolutions. Assist with new or existing staff with training or techniques to increase production and quality. Contact health plans or payers to gather policy benefits and limitations. Analyze eligibility and benefit responses and complete eligibility and benefits verification. Effectively resolve complex aged reports including denials and retro-authorizations.
REFERRAL SPECIALIST, CONCENTRA 08/12 – 10/13
Accurately ran reports and data analysis. Assisted team by accepting and resolving escalated adjuster, clinic and patient calls. Worked under minimal supervision. Assist new or existing staff with training or techniques to increase production and quality. Maintained assigned workques daily. Contacted insurance carriers to obtain authorization needed for diagnostic testing, physical therapy and specialist referrals. Scheduled appointments accordingly. Maintained all referrals within appropriate networks/MSO.
REGISTRATION REPRESENTATIVE ST. MARY’S MEDICAL CENTER 01/2011 – 06/2011
Maintained assigned workques daily. Updated patient accounts by processing payments, setting up payment arrangements and postings. Contacted insurance carriers to determine eligibility, benefits, and pre-certifications needed for out-patient testing and surgeries. Compliance with all healthcare facility, HMO, commercial and insurance requirements. Rapidly learned and mastered varied computer programs and systems. Assisted with Affinity to Epic system conversion. Assisting with Affinity to Epic training for new/old employees.
PATIENT ACCOUNT REPRESENTATIVE, FRANCISCAN ALLIANCE 08/07 – 01/11
Supported upper management in making data driven decisions. Attended meetings with upper management to discuss policy and procedural changes and updates in all areas. Reviewed EOP's and EOB’s (explanation of benefits and payments). Communicated with provider of services to retrieve appropriate medical documentation, work orders, proof of delivery or other documentation to resolve open account issues. Accepted escalated patient calls to minimize dissatisfaction by means of attentive listening, maintaining a helpful and professional tone and acknowledging patient concerns. Escalated patient concerns to the appropriate supervisory level when necessary. Processed all Medicaid, MCO, HMO, and all other commercial insurances. Maintained billing adjustments claims for payment, primary collections workques. Patient Access Department selected for Second Quarter “MVP” Award. Contacted patients for additional information in order to have claims processed and paid.
EDUCATION
ROBERT MORRIS COLLEGE-CHICAGO, IL HEALTHCARE ADMINISTRATION
REFERENCES
REFERENCES AVAILABLE UPON REQUEST
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