Insurance Verification Specialist with Healthcare Focus

PATRICIA ANN RUSS

*** ******* ***** **., **** C, Frederick, MD 21702 301-***-**** ***************@*****.*** Professional Summary

Pragmatic Insurance Verification Specialist touting 6 years of healthcare experience benefits explanation, coverage tracking and authorizations, in addition to other administrative support roles. A team player with a vast knowledge of medical terms and the ability to work with all types of personalities effectively. Offering dynamic organizational skills and attention to detail. Skills

Attention to detail, Medical Terminology Class, Data Entry, Database Fluency, Proficient in MS Word, Excel, Access and PowerPoint, Office Machines, Organization, Efficient, Filing, Scheduling, Multitasking, Time Management, Data Entry, Word Processing, Prior authorization processing, Insurance Eligibility and Verification, Typing 65 wpm, EPIC, HST, Meditech, E-Clinical Works, WebPT, Athena, RIS (Radiology Information Systems), PeopleSoft, QuickBooks Work History

Remote Precertification/Insurance Verification Specialist 4/2024-Present SCA, BIRMINGHAM, AL

• Responsible for Insurance Verification for 2 Centers

• Utilized patient demographics verifying active coverage ensuring claims meet guidelines of insurance carriers’ notification request.

• Proficient use of medical terminology; ICD-10, HCPCS, CPT

• Follow scripted benefits verification/precertification format in HST benefits screen and record benefits and pre-certification information into Inspire.

• Accurately input all patient and insurance information into the company’s computer system using Inspire

• Complete a minimum of 30 accounts a day/per Center. In a normal day completed well over minimum

• Initiate and finalize Insurance Verification requests from Center work list

• Follow up on all pending cases and submit any additional information that is needed to complete case(s) to the Center representative

• Document Inspire and HST with all information obtaining to all cases for both Centers

• Scan insurance authorizations, referral forms, eligibility verifications and approvals into patient accounts into Inspire

Remote Precertification/Insurance Verification Specialist 4/2023-4/2024 Randstad, Frederick, MD

• Utilized patient demographics verifying active coverage ensuring claims meet guidelines of insurance carriers’ notification request.

• Proficient use of medical terminology; ICD-10, HCPCS, CPT PATRICIA ANN RUSS

731 Heather Ridge Dr., Unit C, Frederick, MD 21702 301-***-**** ***************@*****.***

• Follow scripted benefits verification/precertification format in Epic benefits screen and record benefits and pre-certification information.

• Accurately input all patient and insurance information into the company’s computer system using Epic.

• Complete a minimum of 100 accounts a day.

• Initiate and finalize authorization requests from daily work list and submit to insurance companies for approval via phone, web portal and/or fax.

• Follow up on all pending cases and submit any additional information/documents needed to obtain approval.

• Document Epic with all information obtained from insurance companies for each authorization request.

• Scan insurance authorizations, referral forms, eligibility verifications and approvals into patient accounts via Epic.

Remote Precertification/Insurance Verification Specialist 4/2022-3/2023 Radnet, Frederick, MD

• Provided timely notification of scheduled outpatient appointments, utilizing patient demographics verifying active coverage.

• Completed over the 50 accounts required per day.

• Assured timely verification of insurance benefits prior to patient appointments.

• Responsible for obtaining all insurance authorizations for necessary diagnostic imaging on work list.

• Initiate authorization requests and submit to insurance companies for approval via phone, fax and/or web portal.

• Communicate with providers, insurance companies and patients regarding necessary documentation required to obtain authorization approval.

• Document RIS with all information regarding authorization.

• Scan insurance eligibility verification and authorizations to each patient account.

• Reschedule and/or cancel exams as required and/or needed.

• Notify providers of any denial received on authorizations submitted, which included sending denial letter via fax.

• Notified patients of denial and offered them the opportunity to be self-pay.

• Answer phone calls from providers, patients and fellow employees regarding authorization and/or insurance verification assistance.

PATRICIA ANN RUSS

731 Heather Ridge Dr., Unit C, Frederick, MD 21702 301-***-**** ***************@*****.*** Front Desk Receptionist 8/2020-4/2022

UNI Urgent Care, Frederick, MD

• Greet and attend to patients in person and over the phone.

• Professionally assist doctors, staff, visitors and patients.

• Manage patient intake and discharge documentation, oversee insurance verification, communicate with insurance companies, and create payment plans with patients to reduce past due accounts.

• Patient scheduling, field 30-50 phone inquiries per day, obtain medical records, and enhance office operations to minimize wait times.

• Maintain records for 100+ patients ensuring the accuracy of data in Meditech and contacting patients for follow-up, consultations and tests.

• Registered new patients, gathered medical information and records, managed appointment scheduling and oversaw physician calendars.

• Maintain business inventory such as checking supplies, scheduling equipment and maintenance repairs.

• Organized and maintained a clean, efficient, and confidential work environment.

• Perform all duties within HIPAA regulations.

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