Insurance Verification Customer Service

Kimberly Witcher

*************@*****.*** 470-***-**** Atlanta, GA

SUMMARY

Seasoned specialist with 6 years' experience in medical insurance verification, prior authorizations, and referral management. Proficient with EMR systems including Meditech and Epic, adept in ICD-10 and CPT coding. Seeking Medical Insurance Verification Specialist role to leverage expertise in ensuring accurate insurance coverage and compliance.

WORK EXPERIENCE

WVU/Thomas Memorial Hospital South Charleston, WV

Referral/Pre-Certification Specialist Aug 2021 - Jul 2023

• Coordinated patient appointments and obtained necessary prior authorizations for a variety of medical services including procedures, infusions, and imaging, ensuring adherence to healthcare provider directives.

• Conducted insurance verifications and managed the referral process, both incoming and outgoing, while maintaining accuracy in electronic medical records using Meditech and Epic systems.

• Handled administrative tasks such as registration, report generation, order input, prescription refills, chart management, and medical record request submissions, proficient in ICD-10 and CPT coding. CASCI South Charleston, WV

Customer Service Advocate I Aug 2019 - Jul 2021

• Resolved member, provider, and broker inquiries by thoroughly researching and examining claim submissions to ensure accuracy and adherence to policies.

• Verified system data integrity and claimant liability during problem resolution processes to maintain high-quality service standards.

• Clarified policy details and procedures to customers, ensuring comprehensive understanding and satisfaction with issue resolutions.

Dr. Prasuna Jami Charleston, WV

Precertification Specialist Dec 2016 - Jul 2021

• Managed the scheduling and authorization of medical procedures, ensuring compliance with healthcare provider orders and insurance verification protocols.

• Facilitated patient check-in/out processes, efficiently handled copay collections, and maintained accuracy in registration and referral documentation.

• Utilized EMR Cerner to run reports and update patient records, demonstrating proficiency with ICD-10 and CPT coding systems.

EDUCATION

West Virginia State University

Bachelor's Degree, Communications

Dec 2011

SKILLS

Microsoft Office • Quickbooks • Excel • Customer Service • Call Center • CSR • Customer Support • Icd-10 • CPT Coding • Order Entry • Icd-9

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