Insurance Verification Specialist

Miriam J. Macario

** ******* ****, ****** **** NY. 11558

Cell: 516-***-**** / Email: ad7c8n@r.postjobfree.com

SUMMARY:

Experienced Medical Biller, Cash Posting, Insurance Verification Specialist hard-working, with four years of Receptionist/Customer services experience. Committed to maintaining professional relationships to increase profitability and drive business results.

QUALIFICATIONS:

5 year of Insurance Verification Specialist

4 years of Receptionist/ Customer service experience

Bilingual Spanish reading and writing

Cash Posting

Problem solving

Management

Epic,Centricity Group Management, Brigthtree

Typing 50 wpm

Experience ICD 10

●HIPA Guise lines

●Excel knowledge

MEDICAL BILLING EXPERIENCE:

ProHealth Care Associates LLP/Optum Care

Insurance Verification Specialist /Data Entry /Research Analyst

Lake Success 09/2016-03/2025

• Medicare, secondary and 3rd party payers Insurance Verification

• Commercial Insurance

• Online and phone representative Insurance verification and COB billing,

• Investigated type and level of insurance coverage to assess patient eligibility

• Maintains Insurance plan request database, ensuring data is entered accurately and in a timely manner, as determined through facility processes

• 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 .

• Research Analysts internal processes to detect errors that had caused financial injury

• Observations according to their perceived levels of harm and utilizing procedures, critical thinking, • Teamwork to analyze files, documentation, and information in the interpretation of complainant allegations. • Mathematics, communication, and critical thinking

• Research in Payments Unidentified account,

• Research and Analyst Payments received that cannot be posted to patient accounts

Landauer, Medstar

Insurance Verification Specialist Level 3 Great Neck, NY 04/2016 -09/2016

• Medicare, secondary and 3rd party payers Insurance Verification

• Commercial Insurance

• Online and phone representative Insurance verification and COB billing,

• Investigated type and level of insurance coverage to assess patient eligibility

• Maintains Insurance plan request database, ensuring data is entered accurately and in a timely manner, as determined through facility processes

• 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 .

Landauer,Medstar Great Neck, NY 09/2015 – 03/2016 Medical Biller/Cash Poster

• Post cash, Credit cards, ERA’s, credit memos and checks into the computer system

• Ensures that accounts are credited correctly by documenting the account on the copy of EOB or checks. • Transfer posting information to computer system

• Posts accounts receivable adjustments activity in the computer system

• Maintains accurate records and files concerning AR data entry activity

• Communicated problems/concerns with supervisor or with accounting department that could lead to inaccurate or untimely completion of monthly date entry

• Performs other duties as assigned

Femmpro Garden City, NY 05/2015-07/2015 Medical Biller Extern

Billed secondary insurances with primary EOB’s, printed aging reports and appealed denied claims. Contacted insurance companies to investigate unpaid and denied claims

Posted claims, verified insurance information and assisted staff with other responsibilities

Processed and reviewed claims and resent claims to insurance companies

Sent out statements to patients, set up payment plans, and followed up on claim status

Submitted clean claims to various insurance companies either electronically or by paper

Prepared invoices and contacted patients about past due bills

The New Nautilus Hotel Atlantic Beach, NY 01/2009 - 04/2012 Supervised and monitored front desk operation

Supported administered, responsibilities, greeted guests

Answered and forwarded customer calls

Networked with others coworkers on/with a wide range of skills

Bedrock Concrete Inc. Brooklyn, NY 06/2006 - 12/2008 Completed payments and monitored expenses

Verified and reconciled invoices in Quick Books

Scheduled and prepared checks, proposals, invoices and contracts.

EDUCATION:

Sanford Brown Institute Garden City, NY 05/2014-07/2015

Medical Billing and Coding Certificate, GPA 3.9

An intensive 900-hour course comprised of theoretical and practical application of essential Medical billing and Coding skills

Contact this candidate