Medical Insurance Resume

Medical Insurance professionals work as medical insurance agents, claim examiners, health insurance underwriters or information technicians. One of the most common profiles in this field is Medical Insurance Specialist who works in various healthcare organizations, and usually have earned an associate's or a bachelor's degree from an accredited college.

Common responsibilities listed in a medical insurance specialist resume include reviewing and updating patients' records, including medical costs or billing details, examining medical insurance claims, detecting coding errors, verifying insurance eligibility, and medical coverage, explaining medical benefits to patients, processing payments in accordance with healthcare insurance and coding procedures, maintaining communication with insurance providers, patients and doctors. If you are looking for a job in this field, your medical insurance resume should showcase strong communication, customer-service, analytical, and computer skills along with the relevant work experience.

Medical Insurance Resume Sample

Ruby J. Hampton
4209 Cobrun Hollow Road
Peoria, IL 61602
Phone No: 352-894-7327
Email: rubyhampton@anymail.com

Career Summary:

Highly-professional and organized Medical Insurance Specialist with a solid experience in processing medical insurance claims as well as reviewing and maintaining patients' records for billing and reimbursement purposes. Possess excellent customer-service, communication, computer, critical-thinking, and numerical skills along with the knowledge of health insurance and medical coding procedures.

Summary of Skills:

Thorough knowledge of medical billing and coding, including insurance claims process, insurance or benefits verification and authorization as well deep understanding of medical terminology
Effective communication and interpersonal skills to maintain good relationship with patients, insurance companies, and physicians
Excellent customer-service skills to handle patients' inquiries, and issues related to insurance claims and billing processes
Strong computer skills along with the proficiency in using MS Office Suite and database applications, coding software, EHR system as well as Internet
Solid data-entry skills to prepare patients' records and ability to maintain their confidentiality
Exceptional analytical and critical-thinking skills to identify billing errors and make necessary modifications
Excellent organizational and multi-tasking skills along with the ability to assign priority levels and handle huge amount of data

Work Experience:

Medical Insurance Specialist
Legacy Health Group, Peoria, IL
April 2017 - Present

Following up on claims from billing to final resolution and obtaining necessary medical and financial information from patients or doctors as well as contacting different insurance companies for benefit investigation and coverage eligibility
Preparing and reviewing claims as well as identifying and correcting billing errors, and resubmitting claims to insurance companies
Obtaining financial verification and pre-certification or authorization as required for patients' visits as well as documenting the related information according to defined process in a timely manner
Translating insurance benefits to patients as well as answering their questions related to billing procedures, insurance coverage plans, and claim procedures
Maintaining and improving quality results by adhering to established standards and guidelines and recommending improved procedures as well as providing reviews and remittance advice for payment errors, denials, and under payments

Medical Insurance Specialist
Lifetime Healthcare Center, Peoria, IL
February 2015 - March 2017

Managed communication with patients as well as assisted senior medical insurance specialist in monitoring payment requests and verifying claims status with insurance agencies
Reviewed electronic documentation for correct assignment of billing codes and to assure compliance with payer and government standards
Communicated and explained medical benefits to patients as well as advocated on behalf of them to obtain authorizations
Coordinated with payers to evaluate various denial claims, and to maximize reimbursements
Reviewed studies and policies related to healthcare payment processing as well as participated in educational programs and training activities as required to update job knowledge

Assistant Medical Insurance Specialist
Erie Medical Care Groups, Peoria, IL
December 2013 - January 2015

Prepared and maintained patients' insurance records using database application as well as assisted medical insurance specialist in reviewing, verifying eligibility of patients, and processing claims within standard medical codes
Assisted with initiating and obtaining prior authorization from insurance companies, and answered patient coverage questions appropriately
Assisted with reviewing and following-up denials and payments discrepancies that were directly related to verification and authorization processes
Assisted medical coding professionals in detecting coding errors during billing processes as well as kept up-to-date with new coding rules and initiatives
Followed up on submitted appeals until a determination was made by the insurance payers

Education:

Associates Degree in Health Information Technology
Bradley University, Peoria, IL, 61625, USA
2013

Reference:

On request.