Home / Insurance / INSURANCE SPECIALIST

INSURANCE SPECIALIST C.V Example INSURANCE SPECIALIST Resume Sample

The following is an example of a qualified / professional INSURANCE SPECIALIST resume sample(s). These resume examples uses an integration resume layout. The Resume initiates with the applicants qualification profile, outlining key-qualifications for Insurance job field.

Then, the candidate has an outline of their full work experience (employment history) in sequential order with employment dates on file.

Next is the Educational background, listed in descending order (most recent first). It then moves onto the Professional Background, highlighting skills separated into professional & personal skills.

And lastly, Certifications/Licenses that the candidate it involved with. Then a final part displays any other additional information that the candidate want it to be listed.

Resume Example for INSURANCE SPECIALIST

INSURANCE SPECIALIST – MD Anderson@ Cooper University Hospital

Newark, DE

Work Experience

INSURANCE SPECIALIST

MD Anderson@ Cooper University Hospital

Camden, NJ

2016 to Present

To obtain an administrative position where my skills and talents can be explored, natured, and utilized that will allow professional growth within the company 
 
MD Anderson@ Cooper University Hospital-Camden, NJ 2016-present 
INSURANCE SPECIALIST 
 
Financially clears scheduled inpatient and outpatient services, including office visits, testing, 
diagnostic studies, surgeries and procedures, prior to date of service. Financial clearance process 
encompasses any or all of the following job functions: 
• Verifies insurance eligibility and plan benefits. 
• Contacts patients with inactive insurance coverage to obtain updated insurance information 
• Validates coordination of benefits between insurance carriers. 
• Explains insurance plan coverage and benefits to patients, as necessary. 
• Secures insurance authorizations and pre-certs for patient services both internal and external 
to Cooper. 
• Creates referrals for patients having a Cooper PCP. Contacts external PCPs to obtain 
referrals for patients scheduled with Cooper providers. 
• Refers patients with less than 100% coverage to Financial Screening Navigators. 
• Identifies copayment, deductible and co-insurance information. 
• Collects and processes patient liability payments prior to service. 
Provides clear and concise documentation in systems. 
Communicates daily with insurance companies, internal customers, providers and patients.Working knowledge of medical insurance plans & products, coordination of benefits 
guidelines, and requirements for authorizations, pre-certifications and referrals preferred. 
Proficiency in working with payor on-line portals, as well as NaviNet, Passport or other third 
party eligibility systems preferred. Proficiency in IDX Flowcast, Imagecast, and EPIC EMR 
systems preferred. Skilled in use of computers and software applications, i.e., Microsoft Word, 
Excel, Outlook, Access, registration and billing systems.Basic knowledge of medical diagnoses and procedural codes Excellent verbal and written communications skillsAbility to organize

Scheduling Coordinator for Ocular Melanoma

Thomas Jefferson Hospital

Philadelphia, PA

2011 to 2016

* All incoming call to the practice(call center) 
* New patient phone interview 
* Assist the supervisor with other office duties 
* Verify patients insurance 
* Verify patients referrals 
* Inpatient consultations/phone triage 
12 Bunker Hill Ct, Newark De 19702 
302-312-0962 • denmon701@aol.com

Resident Coordinator

Hospital of University of Pennsylvania

Philadelphia, PA

2009 to 2011

Responsible for the clinical and administrative components of the ambulatory internal 
medicine residency experience at The Cooper Practice. This includes managing 53 
residents, 6 attending 
schedules, also use COAST; Speech vantage; PULSE; EPIC; IDX; and Microsoft Excel, 
Word, ACCESS and Outlook to facilitate the academic mission of the practice. 
* review visit types and resident master schedules with Ambulatory Scheduling Team. 
Identifying which attending will precept which sessions as standing assignments, and enter in COAST for 
upcoming year. 
Manage IDX provider dictionary. Create photo grid of new and transitioning residents for the practice. 
Translate COAST schedules to IDX. 
* Perform frequent “bidirectional” checks of IDX and Coast to assure no errors in upcoming schedules. 
Managing preceptors schedules. Using COAST, identifying sessions where extra 
attending help is 
needed. Manage the faculty out-of-office calendar. Incorporating ward coverage and vacation 
schedules. Work with practice manager to block and open clinical sessions affected by vacation, 
conference and out-of-office time. Bring and conflicts or problems to Physician 
Education Coordinators. 
* Assist with preparation of reports from resident QI projects and audits. Maintain 
speech vantage website with correct on-call resident and update with changes. 
* Generate patient list of departing JARs and SARs. Review letter to patients and 
protocol for reassigns with MD coordinators and Ops Plus Group. Send letters to patients of departing 
residents. Prepare 
materials and conference room for orientation. Activate OASIS evaluations. Send 
emails to notify 
residents of upcoming role in presenting. 
* Organize and manage attending and resident attendance sheets. Send emails to attending to remind 
them of dates of talks. Prepare reports on residents practice productivity, patients 
access, Epic 
documentation on request 
12 Bunker Hill Ct, Newark De 19702 
302-312-0962 • denmon701@aol.com

Patient Service Rep/lead

Hospital of University of Pennsylvania

Philadelphia, PA

2001 to 2009

Responsible for multiple patients intake, greeting, verify insurance, collect copays for services, answer calls, schedule follow up and specialty appointments, referral and 
authorizations if needed.

Education

Diploma in Medical Office Management

Thompson Institute of Philadelphia

Philadelphia, PA

1999

High School Diploma

West Philadelphia University City High School

Philadelphia, PA

1984 to 1988

Skills

EPIC (3 years), IDX (3 years), Microsoft Word (1 year), OASIS (2 years), Word (3 years)

Additional Information

COMPUTER SKILLS: 
Microsoft word, excel, access, powerpoint, IDX, COAST, PULSE, OASIS, Speechvantage, 4D 
CLIENT, EPIC, ALLSCRIPTS, JEFFCHART, MEDVIEW, NAVINET, ONTRAC, centricity, sorian, med solutions, 
carecore, NIA, AIM, iexchange.