Insurance Follow Resume Sample
Roy Simonis
1383 Harris Harbor,
New York,
NY
+1 (555) 379 7785
Work Experience
Insurance Follow Up Manager
05/2016
-
PRESENT
Chicago, IL
- Provides timely billing and follow-up of assigned inventory for the purpose of expediting account resolution
- Updates patient accounts to reflect any changes made to relevant information in a timely and accurate manner
- Consistently meets productivity standards established by management, recommending new approaches for enhancing performance and productivity when appropriate
- Responsible for maintaining an appropriate amount of accounts receivable by consistent follow-up on billed, or assigned unbilled, accounts to ensure timely payment
- Ensures complete, accurate and timely documentation of follow up activity in the patient accounting system
- Independently manages assigned accounts daily through appropriate work queues. Reviews and follows up on account balances in a manner consistent with department policies and procedures
- Maintains a thorough knowledge and understanding insurance submission requirements and appropriate resources for payors
Insurance Follow
12/2011
-
02/2016
Phoenix, AZ
- Consistently identifies account deficiencies that require follow up and ensures that appropriate actions have occurred
- Evaluates processes and procedures to make practical suggestions/recommendations for improvements when appropriate
- Keeps Supervisor/Manager informed of any problems or issues
- Organizes and maintains all incoming/outgoing items for the Insurance Follow-up Team
- Categorizes correspondence and distributes to relevant parties in a timely manner
- Mails claims and appeal letters per payer timely filing guidelines
- Sorts and enters correspondence in Epic
- Addresses claim denials under direction
Business Office Insurance Follow
11/2005
-
11/2011
San Francisco, CA
- Data entry of identified adjustments
- Meets collection expectations for assigned accounts
- Maintains a level of professionalism that is a reflection of UHA and the C-I-CARE initiative
- Strong computer skills including experience working with the following
- Previous supervisory experience in a billing environment required
- Knowledge of insurance and reimbursement procedures required
- Set example for team in all areas that relate to job functions and Clinical Pathology Labs’ compliance policies and procedures
Education
University of Mary - Fargo Center
2000 - 2004
School's Degree in Management
Professional Skills
- Strong Problem Solving, Critical thinking and research skills
- Excellent written and oral communication skills
- Prior experience following up on claim status, resolving denials and rejections, re-billings, re-submitting claims, and filing appeals
- Prior experience in medical billing, verifying eligibility, charge entry, and calculating contractual reimbursements
- 2+yrs prior experience with insurance follow-up
- Two years of revenue cycle or related work experience that demonstrates attainment of the requisite job knowledge and abilities
- Validate outstanding claims are billed, received, processed and paid according to carrier contract
How to write Insurance Follow Resume
Insurance Follow role is responsible for research, software, government, travel, insurance, reporting, training, automation, health, transportation.
To write great resume for insurance follow job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Insurance Follow Resume
The section contact information is important in your insurance follow resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Insurance Follow Resume
The section work experience is an essential part of your insurance follow resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous insurance follow responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular insurance follow position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Insurance Follow resume experience can include:
- Communicate effectively and in a professional manner with patients using interpersonal skills
- Communicate effectively and in a professional manner with all staff, managers and physicians
- One (1) to two (2) years of experience in hospital or physician billing/insurance follow up
- Three years of previous medical billing and collections experience
- Previous experience working with third party payers
- Microsoft Office Word/Excel/Outlook, payer portals, and electronic medical records (EMR) software experience
Education on an Insurance Follow Resume
Make sure to make education a priority on your insurance follow resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your insurance follow experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Insurance Follow Resume
When listing skills on your insurance follow resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical insurance follow skills:
- Demonstrated knowledge of medical coding (including CPT, HCPCS, ICD-9/10)
- Strong understanding of participation guidelines
- Strong knowledge of ICD-9, CPT, and HCPCS
- Experience with the most prevalent insurance denial reasons and corrections needed for resolution
- Strong work ethic, and "can do attitude"
- Communicating with customers and/or vendors to resolve customer issues
List of Typical Experience For an Insurance Follow Resume
1
Experience For Insurance Follow Up Manager Resume
- Prior Follow-up Experience
- Working knowledge of the reporting structure, able to balance, research and resolve inconsistencies on reports
- Has complete understanding of interdepartmental issues as well as procedures involving vendor/partner feeds
- Audit account history showing insurance denials to resolve balances to the highest allowable for CPL and to fully utilize our patient’s benefits
- Analyze accounts for underpayments with an understanding of Payer contract
- Follow-up to include commercial and government insurance payers on new and aged claims
- Bill/Rebill Primary and Secondary Payers such as Blue Cross, Commercial, Managed Care, Medicare Managed Care, and Medicaid Managed Care
- Serves as a “lead” resource for other staff in the Follow-Up Representative classification and assists Supervisor/ Manager through the transmission of work instructions and participation in the planning, development, and implementation of new/revised procedures
- Assigns and reviews work to facilitate smooth workflow; assists Manager/Supervisor with hiring interviews, staff orientation/training; provide feedback on staff performance
2
Experience For Manager of Insurance Follow Resume
- Assists with compilation and delivery of staff quality reviews through account reviews and adherence to previously prescribed policies, procedures, and productivity expectations
- Researching accounts and refiling or appealing claims
- Troubleshoots and resolves (within designated scope of authority) more complex problems and/or issues escalated from other staff
- Initiate contacts and negotiate appropriate resolution (internal and external)
- Receive and resolve inquiries and correspondence from third parties and patients
- Serves as a "lead" resource for other staff in the Follow-Up Representative classification and assists Supervisor/ Manager through the transmission of work instructions and participation in the planning, development, and implementation of new/revised procedures
- Analyze accounts for underpayments with a clear understanding of payer contract
3
Experience For Insurance Follow Up Specialist Resume
- Account Follow-up with Commercial, Managed Care, and Managed Medicare and Managed Medicaid payers on aged claims
- Timely, efficient and accurate accounts receivable insurance follow up
- Rebill primary and secondary payers when necessary
- Conduct phone calls on accounts to obtain status
- Request additional information as needed from clients, patients, and insurance companies
- File correspondence and mail received
- Follow protocols as outlined by the department for each program within health insurance
4
Experience For Insurance Follow Up Representative Resume
- Search internet databases for information on insurance company, employer and patient when applicable
- Audit and review accounts as needed to ensure accuracy and efficiency
- Follow up on accounts for underpayments, overpayments, and refunds
- Use Microsoft Office Word/Excel/Outlook, medical software, payer portals, and type 40+WPM
- Remain compliant with HIPPA and other State and Federal regulations
- Request adjustments, write-off, payment, refunds/recoups, and transfers when appropriate
- Work insurance aging reports, review claims status, patient eligibility, accuracy of account information and modify as needed to ensure proper and timely payment while maintaining A/R aging per company guidelines to maximize reimbursement
5
Experience For Business Office Insurance Follow Resume
- Review and reply (as needed) to all insurance correspondence, including assigned carrier newsletters and guidelines as well as maintain a working knowledge of assigned carrier website
- Establish/maintain cooperative working relationships with staff and providers
- Assist with demographics/charge entry and capture of all hospital charges
- Knowledge of appeals, follow up, and denials
- Treat coworkers with respect
- Provide phone feedback, coaching and mentoring on sales and service issues, troubleshooting technical problems with software, provide support on policies, procedures, new or enhanced services and/or procedural changes to service customers, audit paperwork and provide guidance on corrections to customers
- Posses basic knowledge of UB04, HCFA 1500 and Explanation of Benefits
6
Experience For Insurance Follow Up-collections Specialist Resume
- Multi-task in a fast paced environment
- Position in general is sedentary
- Interpret contracts and write appeal letters
- Denial Management, Appeal Submission and Account Escalation
- Proficient in Word, Excel, Internet and Web research
7
Experience For Insurance Follow Up Customer Service Representative Resume
- 60 Day Temp with opportunity for Perm Hire
- Process denied claims
- Secures medical necessity checks/verification in accordance to Centers for Medicare & Medicaid services, verifies insurance, benefits, coverage & eligibility, completes assigned registration financial clearance work lists activities, obtains insurance authorizations for scheduled & unscheduled Hospital services, and secures inpatient visit notification to payors
List of Typical Skills For an Insurance Follow Resume
1
Skills For Insurance Follow Up Manager Resume
- Effectively communicate with insurance companies, employer and/or patients to resolve claims
- Effectively navigate through the FACS system and understand its uses
- Experience in healthcare collections and/or healthcare related field
- Working knowledge of CPT/HCPCS codes, UB, HCFA and other related documents
- Understanding and adherence to HIPAA confidentiality guidelines
2
Skills For Manager of Insurance Follow Resume
- Submitting additional medical documentation and tracking account status by monitoring and analyzing assigned unresolved third party accounts
- Audit patient accounts for accuracy regarding charges, payments, demographics, insurance information and filing to ensure contractual agreements are being met
- Electronic billing/follow-up utilizing any of the following platforms: EPIC, MS4, Artiva, ePremis and nThrive
- Monitor Coding issues for billing compliance
- Back up the sorting and distribute internal in-coming correspondence and daily mail
3
Skills For Insurance Follow Up Specialist Resume
- Answer and process all billing inquires in a prompt and courteous manner, documenting outcomes in the practice
- Maintain confidentiality of patient information including medical records (according to HIPAA and company guidelines)
- Knowledge of working within the Hospital revenue cycle and collecting on inpatient facility charges
- Utilize functionality in application to identify and process denial and unpaid claim queues before timely filling limits occur
- Work insurance aging reports, review claims status, patient eligibility, accuracy of account information and modify as needed to ensure proper timely payment
- Read appropriate carrier newsletters to ensure understanding of guidelines
- Maintain A/R aging per company guidelines
4
Skills For Insurance Follow Up Representative Resume
- Maintain a working knowledge of assigned carrier website
- Field patient and insurance calls regarding patient accounts receivables
- Field patient insurance calls regarding patient accounts receivable
- Trains new or existing staff as requested
- Attends training seminars to maintain competitiveness and remains current on payer practices
5
Skills For Business Office Insurance Follow Resume
- Adaptability to rapid growth and a progressing environment
- Responsible for all aspects of billing, follow up and collection activity
- Process unpaid accounts by contacting insurance companies via web portal or phone
- Collect on Medicare, Medicaid and Commercial payors as well as collect patient outstanding balances
- Performing medical insurance collections for professional or facility services
- Field patient and insurance calls regarding patient account receivables
6
Skills For Insurance Follow Up-collections Specialist Resume
- Work in all areas of the department during peak times, vacations, illnesses, etc
- The Medical Collector is responsible for collecting both inpatient and outpatient claims on behalf of hospitals and physician groups
- Participate in professional development activities to keep current with trends and future guidelines in health care administration
- Report to appropriate Manager any provider issues, computer issues and payor issues
- Edit assigned electronic claim denials/rejects and keep daily log of claim rejections
- Assigns failed/rejected claims to CBO staff or physician practice as appropriate
- Navigate payer websites to facilitate eligibility, claim status, claim corrections, and appeals
7
Skills For Insurance Follow Up Customer Service Representative Resume
- Communicate with patients, staff members of practices, and insurance carriers through their Websites and/or direct
- Communicate with patients, staff members of practices, and insurance carriers through their Websites and/or direct telephone contact to resolve claim issues. Computer/printer, calculator, FAX machine, telephone and photocopy machine
- Answer and process all billing inquires in a prompt and courteous manner, documenting outcomes in the practice management application as the permanent record
- Field patient and insurance calls regarding patient accounts receivable
- Request adjustments, write-off, payment, transfers and refunds/recoups when appropriate
- Review and reply to all insurance correspondence
- Maintain current knowledge of insurance guidelines through newsletters and websites
8
Skills For Insurance Follow Up Rep-day Resume
- Request adjustments, write-off, payment, and transfers when appropriate
- Review and request refunds/recoups for all payers
- Work insurance aging reports, review claims status, patient eligibility, accuracy of account information and modify as needed to ensure proper and timely payment
- Assist with capture of all hospital charges
- Assist with demographic/charge entry of hospital charges
- Follows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is received for all FMG providers
- Identifies potential trends in denials/reimbursement by payer or by type, denial reason, or coding issue and reports to supervisory staff for appropriate escalation
- Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation; maintains confidentiality of medical records
- Communicate effectively with Insurance payers
9
Skills For Per Diem-insurance Follow up Representative Resume
- Establishes and maintains professional and effective relationships with peers and other stakeholders
- Maintains current knowledge of internal, industry, and government regulations as applicable to assigned function
- Be on the phones in a work from home environment
- Medical, Dental and Vision insurance available after 30 days of employment
- 401K & Tuition Reimbursement
- Opportunity for monthly bonuses based upon individual performance
10
Skills For Hospital Insurance Follow Resume
- Bi-yearly pay increases based on individual performance
- Maintains a level of professionalism that is a reflection of the C-I-CARE initiative
- An Internal Drive to Succeed and pride in accomplishments
- Comfortable with being on the phone with various parties for the greatest part of the day – capable of creating a professional and competent presence over the phone
- Handle a high volume of phone calls
- Commercial, Medicare, Medicaid, and Worker's Comp background
- Quickly learn and use FACS payment system and other hospital systems
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