Insurance Verification Specialist Resume Samples

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Insurance Verification Specialists are employed by insurance companies to process insurance claims. Key responsibilities listed on an Insurance Verification Specialist include checking insurance information, performing data entry tasks, overseeing insurance claims reimbursements, and approving or denying claim processing. Eligible candidates for the job mention in their resumes qualifications like insurance claims expertise, analytical thinking, communication and writing skills, attention to details, and computer competencies. Successful resume samples make display of a college degree in a relevant field. On-the-job training is provided by most employers.

1

Insurance Verification Specialist

Verified health insurance policies for all major commercial carriers, as well as government healthcare agencies.

  • Served as a cost containment resource for Medicaid by ensuring they remain the "payer of last resort" by checking for other primary payer coverage.
  • Ensured accurate data entry into healthcare verification applications.
  • Entered pertinent information in a timely manner while paying special attention to detail.
Candidate Info
5
years in
workforce
2
years
at this job
Licensed Massage Therapist
2

Registration and Insurance Verification Specialist

Trained new hires on standard operating procedures, safety rules, procedure manuals, operating and maintenance instructions

  • Assisted with implementing departmental programs to improve performance and employee morale
  • Offered recommendations to management for improvements in operational efficiencies
  • Complied with federal regulations, including HIPAA provisions
  • Examined pertinent information to determine the accuracy of client requests and related paperwork
  • Maintained and revised procedural lists, control records and coded schemes to process source data
  • Supported and complied with all company policies, processes and procedures including the Compliance Program and the Code of Conduct
  • Reviewed and resolved discrepancies in received data and performed data verification routines in accordance with company procedures
  • Assisted in scanning and re-scanning overlooked requisitions
Candidate Info
39
years in
workforce
8
years
at this job
HS
High School Diploma
Education-medical
3

Order Review/insurance Verification Specialist

Verified insurance information by phone as well as via website, updated files with the most accurate coverage updates

  • Assured that all requirements necessary are present per insurance verification
  • Reported any errors found as well as recommended resolution
  • Reported training issues to management to improve quality control
  • Updated insurance codes to ensure claims process successfully
Candidate Info
8
years in
workforce
1
year
at this job
HS
High School Diploma
4

Insurance Verification Specialist

Initiating contact with insurance companies for verification of benefits and authorization of inpatient and outpatient services.

  • Ensuring that all insurance information needed for billing and collection processes are appropriately obtained and recorded in the computer system.
  • Contacting patients and pre-registering outpatients as assigned.
  • Ensures medical necessity is completed prior to testing.
  • Informs patients of their financial responsibility for services to be rendered.
Candidate Info
11
years in
workforce
5
years
at this job
Medical Assistant
5

Insurance Verification Specialist

Verified patients coverage for all patients needing genetic testing's performed: Medicare, Medicaid, Commercial coverage plans

  • Initiated the pre-authorizations/pre-determinations for insurance to get verified and processed correctly
  • Followed up with decisions from providers
  • Communicated with both patients and primary care physicians (PCP's) and/or specialists in regards to standings
  • Communicated with patients about their estimated out of pocket payments
  • Followed up with doctors office with authorizations
  • Faxed and emailed LOMN (letter of medical necessity) with clinical notes to provider for authorizations
Candidate Info
11
years in
workforce
1
year
at this job
HS
High School Diploma
BA
Bachelor of Arts
6

Insurance Verification Specialist

Contact insurance companies as required to obtain and enter accurate benefit information to positively impact insurance processing and minimize rejections.

  • Effectively research and resolve prescription processing rejections to ensure patients receive medications within established patient standards.
  • Answer and respond to calls regarding insurance related issues in courteous, professional manner.
  • Effectively electronic medical claim billing according to insurance policies and regulations.
Candidate Info
3
years in
workforce
2
years
at this job
7

Insurance Verification Specialist

Generated billings for many major insurances throughout the United States for prescription and medically billed medications, including overrides, J codes, ICD-9 diagnosis codes and special billing codes.

  • Medicare B billing experience with oncology and transplant medications.
  • Online and phone representative insurance verification and COB billing, as well as manufacturer, grant or other secondary funding.
  • Ability to multi-task and resolve issues independently, as well as assist others with issues.
  • Training new employees in the department.
Candidate Info
22
years in
workforce
5
years
at this job
English Language And Literature
8

Customer Service - Insurance Verification Specialist

Conducted insurance verifications and authorizations

  • Initiated the admissions process for patient referrals
  • Investigated type and level of insurance coverage to assess patient eligibility
  • Documented referral request for coordination of care
Candidate Info
8
years in
workforce
3
months
at this job
C
Medical Billing And Coding
AS
Business Management
9

Referral Coordinator / Insurance Verification Specialist

Processing Emergency, Urgent and Routine patient specialist referrals for 38 medical offices.

  • Complete Prior Authorization, Insurance Verification, Scheduling Appointments and coordination all patient medical and demographic information necessary to process the referral.
  • Follow up on patient appointment and receipt of appointment notes to close referral.
  • Use problem solving, customer service and adapt to changing priorities to overcome issues that arise.
  • Familiarity with EPIC, ICD-9 and CPT coding, Medical Terminology and all patient demographics.
  • Verifying patient insurance / demographics in a timely manner prior to or for same-day appointments to ensure error-free claims processing in a fast paced environment.
  • Correcting errors in various work queues to ensure correct claim filing or refiling of denied claims.
Candidate Info
23
years in
workforce
3
years
at this job
BS
Health Care Administration
10

Insurance Verification Specialist Supervisor

Project Manager for ICD-10 implementation

  • Verifies all patient eligibility, authorizations and benefits, claim information with insurance companies, and 3rd party payers prior to surgery.
  • Determines patient portions due, amounts to be billed, contractual discounts to be taken, or any other authorized discounts that may apply. Communicates this information with appropriate personnel for preparation of the pre-admission process.
  • Identifies all patient accounts accurately based on what PPO, HMO, or other Managed Care Organizations the patient's insurance plan might fall under.
  • Contacts patients and provides updates on benefit verification information, requests additional information, insurance cards, and explains to the patient his or her financial responsibility such as co-pays, co-insurance, co-deductibles, at time of service.
  • Notifies CBO Director/BOM of any insurance carrier information changes.
  • Maintains insurance plan request database; ensuring data is entered accurately and in a timely manner, as determined through facility processes.
Candidate Info
9
years in
workforce
4
months
at this job

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