Insurance Verifier Resume Samples

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Guide the recruiter to the conclusion that you are the best candidate for the insurance verifier job. It’s actually very simple. Tailor your resume by picking relevant responsibilities from the examples below and then add your accomplishments. This way, you can position yourself in the best way to get hired.

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D Steuber

Darwin

Steuber

782 Roscoe Neck

Chicago

+1 (555) 246 0987

782 Roscoe Neck

Chicago

Phone

p +1 (555) 246 0987

Experience Experience

Philadelphia, PA

Insurance Verifier

Philadelphia, PA

Upton-Renner

Philadelphia, PA

Insurance Verifier

Performs other job-related duties within the job scope as requested by Management of Patient Accounts
Assists on various special projects as determined by the Manager
Presents a positive, professional appearance and conveys a professional demeanor in the performance of assigned duties
Collaborates with Appeals department to provide all related information to overturn claims denied
Make necessary telephone or written contact with payer or utilizes electronic eligibility software to very insurance coverage
Review and work all daily correspondence received from patients and payers
Monitors insurance authorization issues to identify trends and participates in process improvement initiatives

Phoenix, AZ

Escalated Insurance Verifier

Phoenix, AZ

Kub, Miller and Emmerich

Phoenix, AZ

Escalated Insurance Verifier

Notify management of improper payer behavior trends found on accounts worked or being worked by others on the Clinical Authorization team
Assist Lead with implementation of training workshops and training for new verifiers as assigned
Assist Manager and/or Team Lead in assigned tasks and projects as requested by the deadline
Demonstrate a high level of communication among peers and management in all departments
Additional duties as assigned by your Manager
Assist in reduction of AR due to No authorization
Assisting verification or collection staff with account questions when presented

present

Dallas, TX

Insurance Verifier & Procedure Scheduler

Dallas, TX

Kiehn, Emmerich and Daugherty

present

Dallas, TX

Insurance Verifier & Procedure Scheduler

present

Manages patient calls, works as a member of the front office team and assists in supporting other office personnel
Performs other duties as assigned or requested
Reviews monthly doctor’s schedules and makes changes accordingly
Gives instructions (appointment policies and preps) for all procedures scheduled
Schedules and re-scheduled patient appointments
Inputs information into scheduling book and/or scheduling system
Confirms appointments and gives directions to patients and their families regarding procedure and sends confirmation follow-up letter

Education Education

Bachelor’s Degree in Creativity

Pepperdine University

Bachelor’s Degree in Creativity

Skills Skills

Basic skills - able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately
Ability to multi-task, demonstrate proficiency in computer skills and exhibit excellence in written and verbal communication
Strong attention to detail
Working knowledge of basic medical terminology
Solid documentation skills
Ability to utilize Electronic Health Care Record system for documentation to patients account/record
Highly organized
Able to multitask efficiently and effectively
Great interpersonal skills
Polished and professional demeanor

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Insurance Verifier Resume Examples & Samples

1+ year of prior Authorization / Referral experience
Previous experience with Medical Insurance
Computer savvy

Insurance Verifier Resume Examples & Samples

3+ years of business office or related insurance experience
Knowledge of third party requirements as they relate to insurance verification / authorization
Polished and professional demeanor
Proficiency with computer platforms and applications

Insurance Verifier Resume Examples & Samples

Knowledge of Third Party requirements as they relate to Insurance Verification / Authorization
Solid problem solving and time management skills
Exceptional phone etiquette

Insurance Verifier Resume Examples & Samples

Supports and adheres to all company and Center policies and procedures
Displays willingness to speak up about safety issues or change practices to enhance safety; asks for help when needed; enhances teamwork; follows the safety literature/policies
Communication – Communicates clearly, concisely and professionally
Contributing to Team Success–Actively participates as a member of the Center’s team to move the team toward the completion of goals
PC Skills – Demonstrates proficiency in Microsoft Office (Excel, Word, Outlook) applications; knowledge of, or ability to learn, AdvantX – Accounts Receivable System, Smart, HOST and other systems as required. Demonstrates ability to type on PC keyboard

Medical Office Insurance Verifier Resume Examples & Samples

Organization – Proactively prioritizes needs and effectively manages resources and time
Customer Orientation –Maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
Decision Making – Identifies issues, problems, and opportunities; compares data from different sources to draw conclusions; uses effective approaches for choosing a course of action or develops appropriate solutions; takes action that is consistent with available facts, constraints, and probable consequences
Contributing to Team Success – Actively participates as a member of the Center’s team to move the team toward the completion of goals

Insurance Verifier Resume Examples & Samples

Verifies patient insurance coverage of medications, administration supplies and related pharmacy services
Facilitates and completes the Prior Authorization process with insurance companies and practitioner offices
Completes a full Medical Verification for all medications, administration supplies and related pharmacy services
Notifies patients, physicians, practitioners and/or clinics of any financial responsibility of services provided and requested services that are not provided by the facility
Facilitates pharmacy and/or major medical claims with insurance companies and practitioner offices and investigates and facilitates prior authorization any other insurance rejections
Provides notification of urgent orders to the Senior level or Group Supervisor and communicates with other departments when an urgent need for filling a prescription or delivery is necessary; Places outbound calls to patients or physicians offices to obtain additional information needed to process the script or to notify of delay in processing script
High school Diploma/GED
At least 1 year insurance verification and/or pharmacy technician experience OR at least 6 months specialty pharmacy experience
Basic level skill in Microsoft Word (for example: opening a document, cutting, pasting and aligning text, selecting font type and size, changing margins and column width, sorting, inserting bullets, pictures and dates, using find and replace, undo, spell check, track changes, review pane and/or print functions)
At least 1 year experience in obtaining prior authorizations, pharmacy benefit or medical billing experience
Experience in a healthcare or pharmacy setting
At least 1 year experience in a call center

Insurance Verifier Resume Examples & Samples

At least twelve (12) months prior experience obtaining pre-certifications in a physician office or hospital setting is required or at least twenty-four (24) months registration/insurance experience is required
Hospital or physician office coding experience is preferred
Must be able to manage high volumes of work within strict deadlines and perform duties without prompting and with very little supervision

Medical Insurance Verifier Resume Examples & Samples

Make necessary telephone or written contact with payer or utilizes electronic eligibility software to very insurance coverage
Send appropriate correspondence in a timely manner per standard procedures
Ensure consistent follow-up on outstanding accounts
Review and work all daily correspondence received from patients and payers
Perform audits on accounts as needed
Completes appropriate account maintenance by ensuring that the correct statement groups, financial class, and payer codes are current and timely
Maintain strict confidentiality in accordance with HIPAA regulations and Company policy
Presents a positive, professional appearance and conveys a professional demeanor in the performance of assigned duties
Performs a variety of other duties

Insurance Verifier Resume Examples & Samples

Verify insurance information is accurate with parents/patients
Review the insurance verification form submitted by the hospital associate, to ensure payer coded correctly
Resubmits corrected claim to the carrier
Maintain a log of registration errors identified and submit to the management as needed
Any patient private health information (PHI) must not be divulged on any account except to payers that need the information in order to process the claim for payment

Insurance Verifier Resume Examples & Samples

Answer telephones using correct telephone etiquette at all times, recording legible and complete messages, handling questions, transferring incoming calls appropriately, contacting physicians, insurance companies, hospitals, diagnostic facilities, billing departments, etc… as necessary
Reception desk and telephones as needed
Handle high volume incoming calls
Performs check in and check out duties to include scheduling new and follow up appointments

Insurance Verifier Resume Examples & Samples

Greet and check in patients scheduled for surgeries and procedures
Promptly, accurately and efficiently verify patients insurance including coverage, eligibility, benefits, calculate co-pays, co-insurance and/or deductible estimates per the payer contract as applicable and notify the patient at least 5 days prior to the date of service
Calculate co-pay and estimated co-insurance due from patients per the individual payer contract and plan as applicable
Accurately and professionally discuss financial obligations with each patient
Accurately follow process for collecting over the counter payments/deductibles/co-pay/co-insurance
Comply with all Center/SCA policies, procedures, mission, vision and values
Required – High School diploma or Equivalent
Required – 1 year experience as Insurance Verifier preferably in Ambulatory Surgery Center
Required – Excellent communication skills and ability to handle difficult situations
Required – Familiar with and understand Medicare, Medicaid, other government payers, commercial and HMO/PPO Payers guidelines and principals
Required – Type at least 45 WPM with accuracy
Required – Proven ability to work under pressure to meet strict deadlines
Preferred-1 year Billing experience
Preferred – Proficient in Microsoft Office Suite including Word, Outlook and Excel
Ability to work quickly and effectively while maintaining a calm atmosphere
Must be available flexible hours

Insurance Verifier & Procedure Scheduler Resume Examples & Samples

Schedules and re-scheduled patient appointments
Schedules all hospital, clinical and office based related procedures
Gives instructions (appointment policies and preps) for all procedures scheduled
Confirms appointments and gives directions to patients and their families regarding procedure and sends confirmation follow-up letter
Contacts appropriate departments to schedule and also convey all pertinent patient information
Inputs information into scheduling book and/or scheduling system
Reviews monthly doctor’s schedules and makes changes accordingly
Screens and reviews incoming faxes and referral forms
Makes any needed or required changes to schedules as need to accommodate for the day or the physician
Obtains authorizations on all scheduled procedures
Manages patient calls, works as a member of the front office team and assists in supporting other office personnel
Performs other duties as assigned or requested
Associates degree (A.A.) or equivalent from a two-year college or technical school
Six months to one-year related experience and/or training
Hospital, clinical and office-based procedure scheduling experience
Professional telephone etiquette
Knowledge of insurance authorization procedures
Strong computer skills that include but not limited to Microsoft Windows, Excel, Office 365
Strong knowledge of medical terminology
Equivalent combination of relevant education and experience will be considered

Insurance Verifier Resume Examples & Samples

Experience with insurance verification and/or as a pharmacy technician
At least 1 year of experience in obtaining prior authorizations, pharmacy benefit or medical billing experience
At least 1 year of insurance verification and/or pharmacy technician experience OR at least 6 months specialty pharmacy experience

Insurance Verifier Resume Examples & Samples

Verifies insurance benefits for patient exams being performed at Hawthorn Medical. Determines the appropriate insurance coding and financial class (ATB) routing, for appropriate recording of revenue, and payment for site and read fees
Records all insurance benefit and certification information in the applicable computer system and/or paper forms. Completes and distributes all paperwork required by insurance and Imaging department
Gathers all necessary information from secretaries to obtain pre-authorizations and pre-certifications as stipulated by each individual health plan for Diagnostic Imaging services and communicates with scheduling when additional information is required
Answers the phone and greets patients and staff members politely and efficiently. Answers and directs phone calls courteously. Able to handle multiple phone calls efficiently
Cross-covers other administrative staff within Imaging Department as needed / assigned. Positions include and are not limited to Film Librarians, Imaging Department Secretary, and Centralized Schedulers

Insurance Verifier Resume Examples & Samples

Make necessary telephone or written contact
Contact payers or utilizes electronic eligibility software to verify insurance coverage
Medifax payers to verify insurance coverage
Contact parents to obtain accurate insurance information
Send appropriate letters
Consistent follow-up on outstanding accounts by working correspondence
Verifies insurance coverage on all accounts > $5,000.00 within the first 30 days of admission
Perform audits on accounts when needed
Review accounts to ensure the correct payer code was selected
Reviews the insurance verification form submitted by the hospital associate, to ensure payer coded correctly
Maintains a log of registration errors identified and submit to the Hospital Associate Manager as constructive feedback
Update accounts as necessary
Update accounts in GPMS with information obtained through correspondence and telephone (ie; insurance, authorization, baby’s name, etc.)
Meet or exceed required departmental productivity standards on a consistent basis
Average of quality and quantity productivity standards must meet or exceed 94%
Assists on various special projects as determined by the Manager
Always meets deadline dates and times on assigned projects
Work overtime in mandatory situations
Maintain strict confidentiality in accordance with HIPAA regulations and Company policy and any patient private health information (PHI) must not be divulged on any account except to payers that need the information in order to process the claim for payment
Performs other job-related duties within the job scope as requested by Management of Patient Accounts
Embodies the principles of the corporate Mission Statement and Philosophy at all times
Represents the corporation in a positive fashion and makes all individuals feel as comfortable as possible
Conducts all business in a professional manner maintaining respect for individuals at all times
Complies with departmental and company-wide policies and procedures
Maintains constant awareness of potential safety hazards insuring necessary safety precautions
Reads and complies with established policies and procedures
One-year certificate from college or technical school; or one to two years related experience and/or training; or equivalent combination of education and experience
Ability to add and subtract two digit numbers and to multiply and divide with 10's and 100's. Ability to perform these operations using units of American money and weight measurement, volume, and distance
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations
Understanding of medical terminology and protocols

Insurance Verifier Resume Examples & Samples

A minimum of 5 years admitting/registration/insurance verification or equivalent healthcare experience
Prior leadership experience required
Knowledge of insurance and payors required
Ability to communicate effectively verbally and written
Must have strong customer service and computer skills
High school graduate required
Medical/healthcare related courses preferred
Bilingual preferred

Insurance Verifier Resume Examples & Samples

Proven knowledge of insurance verification, registration, and medical terminology
Possess a thorough working knowledge of third party insurance payers and Federal/State public programs
Ability to interact effectively with the public, including patients, visitors, clinical and support staff
Must possess superb customer service skills
Ability to multi-task, demonstrate proficiency in computer skills and exhibit excellence in written and verbal communication
Must be highly proficient with MS Office applications (Excel, Word)
Demonstrated knowledge of medical terminology

Insurance Verifier Resume Examples & Samples

A minimum of one (1) years’ experience in customer service in healthcare (clinic or hospital) registration
Experience working with insurance verification and authorizations
Demonstrated knowledge of CPT and ICD10 coding and medical terminology
Knowledge and experience with State, Federal and other regulatory Compliance Regulations including: Medicare Secondary Payer, EMTALA ad ABN
High School Diploma or GED equivalent
Able to interpret Insurance benefits for outpatient and inpatient surgery strongly preferred
Inpatient notification
Knowledge of insurance billing and managed care preferred
Some college level course work preferred particularly Medical Terminology or Medical Assistance coursework
Previous registrar, pre-registration, insurance verification and third party payer experience
Healthcare experience in a hospital or clinical setting, health insurance or medical office
Certified Healthcare Access Associate (CHAA) or Certified Revenue Cycle Specialist (CRCS)

Insurance Verifier Resume Examples & Samples

2 years of experience in healthcare
Experience in a pediatric hospital
Working knowledge of basic medical terminology
Demonstrated multitasking and problem-solving skills
Ability to work independently in a changing environment and handle stressful situations
Must pass typing test with at least 50 words per minute
Demonstrated arithmetic and word mathematical problem-solving skills
Must be able to speak and write in a clear and concise manner to convey messages and ensure that the customer understands whether clinical or non-clinical
Proficient in Microsoft Word/Excel/Outlook, SMS, Epic, CSC Papers, scheduling systems (e.g., NueMD, RIS, SIS), IMS Web, Report Web, and insurance websites (e.g., BCBS, RADMD, WebMD, Wellcare, Amerigroup, UHC)
Must be able to successfully pass the Basic Windows Skill Assessment at 80% or higher rating
May require travel within Metro Atlanta as needed
Strives for adult-to-adult relationships with colleagues, subordinates, and superiors
Interviews patients and/or family members as needed to secure information concerning insurance coverage, eligibility, and qualification for various financial programs
Coordinates and performs verification of insurance benefits by contacting insurance provider and determining eligibility of coverage and communicates status of verification/authorization process with appropriate team members in a timely and efficient manner
Provides clinical information as needed, emphasizing medical justification for procedure/service to insurance companies for completion of pre-certification process
Confirms referring physician has obtained prior authorization as needed from insurance company for all scheduled healthcare procedures within assigned department/area
Contacts referring physicians and or/patients to discuss rescheduling of procedures due to incomplete/partial authorizations
Acts as liaison between clinical staff, patients, referring physician’s office, and insurance by informing patients and families of authorization delays/denials, answering questions, offering assistance, and relaying messages pertaining to authorization of procedure/service
Maintains tracking of patients on schedule, ensuring that eligibility and authorization information has been entered into data entry systems
Pre-screens doctor’s orders (scripts) received for new patients to ensure completeness/appropriateness of scheduled appointment
Collaborates with Appeals department to provide all related information to overturn claims denied
Monitors insurance authorization issues to identify trends and participates in process improvement initiatives
Responds to all inquiries from throughout the system and outside related to authorization/pre-certification issues
Provides ongoing communication to physician offices, patients/families, and others as necessary to resolve insurance authorization issues

Insurance Verifier Resume Examples & Samples

High School Diploma or equivalent. Bachelor Degree preferred
Two (2) years healthcare experience required. Pediatric hospital experiences a plus
Working knowledge of Basic Medical Terminology
Demonstrated multi-tasking and problem solving skills
Demonstrated arithmetic and word mathematical problem solving skills with a score of at least 75%
Must be able to speak and write in a clear and concise manner in order to convey messages and ensure that the customer understands, whether customer is clinical or non-clinical
Proficiency in Windows (Word, Excel, Outlook), SMS, EPIC, CSC Papers, Scheduling systems (Nuemd, RIS, SIS), IMS Web, Report Web, and websites for insurance payers (BCBS, RADMD, WebMD, Wellcare, Amerigroup, UHC). Must pass Windows Basic Skills Competency test with at least an 80%

Insurance Verifier Resume Examples & Samples

High school graduate or equivalent combination of education and experience
One year previous experience or some hospital clerical experience or medical terminology preferred
Must have the skills necessary to operate the office equipment required to fulfill job duties
Forty-five (45) wpm typing skills required
Medical terminology and computer experience beneficial

Insurance Verifier Rep-franciscan Medical Group Resume Examples & Samples

Responds to general questions from patients, staff and others regarding insurance coverage and authorizations
Collects on balances for services in an accurate and timely manner using established processes and procedures
Performs end-of-day payment reconciliation; closes out cash drawers; ensures that outstanding work is completed or assigned to other staff
Adheres to and exhibits our Core Values of Reverence, Integrity, Compassion and Excellence
One year of experience in a medical office or healthcare environment where knowledge of medical terminology, insurance companies and codes as well as policies and procedures was necessary to perform the job

Insurance Verifier Resume Examples & Samples

Knowledge of standard insurance companies and verification requirements
Well versed in authorization processes for all payers
High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires)

Insurance Verifier Days Resume Examples & Samples

Gathers required information from the scheduling module to ensure all scheduled patients are authorized prior to date of service
Reviews the Denial/Rejection list from Denials Management and determines cause for denials, provides Patient Accounting with documentation if the denial is inappropriate, educates the staff concerning errors that caused the denial, communicates with Managed Care department regarding discrepancies in information obtained from contracted insurance carriers
Ensures accurate demographics and proper identification of each patient by verifying social security number, date of birth and spelling of name
Determines proper financial class and insurance codes by requesting insurance information and assigning current code as specified in pneumonic index
Makes initial attempt for all scheduled visits to obtain precert/authorization/referral prior to date of service by calling appropriate insurance or by verifying electronically whenever appropriate
Completes authorization and referral process within established time frames according to Patient Financial Services goals as observed by Manager
Maintains accuracy of registration by entering correct clinical information regarding physician, complaint and diagnosis
Protects the legal and financial standing of Florida Hospital East Region by obtaining appropriate authorization forms, and other forms as required for the insurance plan
Adheres to the Florida Hospital Corporate Compliance plan, and to all the rules and regulations of all applicable local, state, and federal agencies and according bodies
Reviews missing authorizations the day before scheduled visit, and obtain necessary authorization/referral or notify scheduling to reschedule patient
Assists in registration and/or scheduling when necessary to maintain the department’s efficiency
Contributes to the attainment of Patient Financial Services Days in Receivable goals by communicating to the registrar all benefits and patient responsibility so that accurate collections are made at time of service
Responsible for insurance verification process for Scheduling Outpatients, Inpatients and Same Day Surgery patients as assigned
Must have typing skills of at least 40 wpm
Proficiency in the performance of basic math functions, capability to communicate professionally with an acceptable use of English and spelling
Most work is repetitive, and new situations arise frequently, which require good judgment in the application of available policies and procedures
Must use good judgment and take initiative to resolve immediate or urgent problems
Must be proactive in developing processes to improve efficiency and services of the Verification area
Must be able to act quickly when emergency situations occur, such as fire, security or disaster
Must be able to coordinate multiple projects at the same time and maintain professional demeanor
Must be a quick learner and have excellent memory in order to process accounts in a timely manner
A high school education or equivalent is required

Lead Insurance Verifier / Trainer Resume Examples & Samples

Verifies all insurance benefits for Inpatient, Observation, surgical procedures, scheduled procedures and other high dollar procedures to determine if insurance coverage meets the standards of admission
Prioritizes daily work flow appropriately and complete assigned HSV and payors timely and in advance of scheduled service. Maintain 3-5 day verifications
3 Correct note format is followed and complete. Comment codes are used correctly. Utilizes proper scripting when verifying benefits via telephone call
Meets insurance verification productivity. 40-60 radiology per 8 hr. shift, 60-80 per 8 hr. shift for Medicare radiology, or 20-40 for surgeries per 8 hr
Willingness to cross-train in “other duties assigned” and learn additional functions to assist in achieving verification department goals
6 Achieve and maintain verification department QA accuracy of 98% or greater
Utilizes policies, bulletins , websites and any other means to reduce denials, and medical necessity issues
Calculate estimated patient cost share based on contract guidelines. Adds patient accounts to call list to ensure follow-up by PAR
Performs other duties as assigned or requested by manager, director, CFO or CEO
Provides new employee and current staff ongoing training in a positive manner while adhering to the best practice processes of the dept
Submits clear and timely documentation of all training sessions and schedulers progress in order to identify shortcomings and those not meeting the minimum requirements for the position
Maintains working knowledge of dept. best practice processes and protocols in order to be a 1st level resource for scheduling staff
Completes routine audits to determine staffs’ compliance with best practice processes to identify reeducation needed

Lead Insurance Verifier Resume Examples & Samples

Ascertain insurance information from patient's prior to service
Obtain authorization for procedures and services, as required
Support the Patient Accounting Manager to support the team in answering questions from the other team members

Insurance Verifier Resume Examples & Samples

Good organizational skills and the ability to multi-task
Good communication and telephone skills
Good computer skills; must be able to type 45 wpm
Knowledge of medical insurance/authorization process
Medical Manager experience preferred

Escalated Insurance Verifier Resume Examples & Samples

Act as a resource to the Team Lead and manager for any of escalation account issues
Utilize all available resources for optimum achievement of goals (Websites, publications, payer and 21 C payer contracting updates, coding and apply these changes to the workflow
Review MARS for proper verifications and authorizations
Assist Lead, collectors, insurance verifiers, and Manager with identifying areas of opportunity with regard to streamlining processes, automation, goals, Kaizen events and the overall group mission
Demonstrate a high level of communication among peers and management in all departments
Special Projects Reporting as needed
Assist Manager and/or Team Lead in assigned tasks and projects as requested by the deadline
Obtaining required referrals and authorizations prior to services via phone, fax, online etc
Review Office Schedules daily for patient accounts requiring authorization, referrals & insurance verification
Obtain retro authorizations in a timely manner
Scan authorization requests, approvals ect into imaging in Intergy
Coordinating any insurance verification needs from the patient with the office
Updating the patient account with details of the insurance verification in the CIVU questionnaire
Follow up with FD or FC when documents are required to assist with insurance verification/authorization process
Keep up to date on authorization / referral requirements from the insurance plans
Verifying Medicare for SNF dates & informing the FC & billers when appropriate
Verifying ALL Self Pay patients for Medicaid monthly & notifying the FC & billers
Re-verify ALL patients monthly for active, current insurance
Researching account insurance questions to find the correct answer
Assisting verification or collection staff with account questions when presented
Staying current with insurance verification processes
Additional duties as assigned by your Manager
Maintain a positive and respectful attitude
ICD-10 & CPT coding experience

Insurance Verifier Resume Examples & Samples

Interface with patients and families, physicians and staff
Update patient demographics/information in system
Verify insurance benefits, obtaining proper authorization from insurance carrier
Determine what funds to collect upon admission
Notify patients of monies due and document in billing system
Other duties as required or requested by chain of command
Ability to utilize Electronic Health Care Record system for documentation to patients account/record
BLS required