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Click here or scroll down to respond to this candidateCandidate's Name
Statesville, NC Street Address
PHONE NUMBER AVAILABLEEMAIL AVAILABLESelf-motivated Insurance Verification Specialist proudly offering over 8 years' experience building an understanding of medical terminology while tracking patient coverage. A poised professional with benefits explanation and administration expertise. Offering time management and interpersonal skills. Proficient in CRMStatement preparationCustomer ServiceAnalytical ThinkingAttention to DetailElectronic authorization processingMedical BillingInsurance Coverage VerificationProblem-SolvingBilingualAdaptableCommunication and Interpersonal SkillsHIPAA Compliance01/2017 to CurrentSMILES BY DESIGN DENTISTRYSalisbury, NCInsurance Verification SpecialistReviewed medical records to ensure accuracy of required information needed for pre-authorization requests. Verified patient eligibility for insurance coverage by contacting insurance carriers and obtaining the necessary authorization numbers.Maintained accurate documentation on all pre-authorization requests, denials and appeals. Provided timely follow up with payers regarding payment status of claims. Updated patient and insurance data and input changes into company computer system. Entered data in EMR database to record payer, authorization requirements and coverage limitations. Contacted patients to arrange payment arrangements for deductible and out-of-pocket liability. Retained strong medical terminology understanding in effort to better comprehend procedures. Adhered to HIPAA requirements to safeguard patient confidentiality. Answered telephones and directed calls to appropriate medical or adminstrative staff. Managed front office customer service, appointment management, billing and administration tasks to streamline workflow.Prepared reports, invoices, letters, or medical records using word processing, spreadsheet, or other software applications.08/2014 to 01/2017STATESVILLE FAMILY MEDICINEStatesville, North CarolinaInsurance Claims SpecialistReviewed customer insurance claims to ensure accuracy and completeness of information. Analyzed claim records, policy provisions, and other relevant documents to determine validity of claims. Assisted customers in filing new insurance claims and provided status updates on existing ones. Provided guidance to customers regarding their rights and obligations under the insurance policies. Resolved customer complaints related to insurance claim processing. Reviewed denied claims for errors or omissions before finalizing decision notices. Supported efficient handling of complex claims and followed up on open, denied or suspended claims to complete required line items.Collected payments, processed receipts and informed policyholders of outstanding balances. Precisely calculated refunds, premiums and adjustments. 06/2008Statesville High School, Statesville, NCSUMMARYSKILLSEXPERIENCEEDUCATION AND TRAINING |
