Insurance Verification Specialist
Laguna
I have more than 9 years of experience in the US healthcare and medical insurance industry. As a medical biller, my task is to do claims towards resolution by calling insurances, using email, websites or provider portals to ensure that the claim will be processed correctly and the claim will be paid accurately. I'm also requesting prior-authorization, insurance verification, eligibility and benefit. submit corrected claims, medical records/appeals and do some payment posting. Addition to that, I also learned how to use or navigate EHRs like eCW, EPIC, Athenahealth, practice fusion, medevolve, ACE, Atlas and Vi-web. I strongly believe that the skills that I acquired through my experience are a great advantage for me to meet and exceed your organization's expectations. With my knowledge in the US healthcare and medical insurance industry, as well as my excellent work ethic, I am confident that I can be one of your best medical billers. Thank you.
MedVirtual, full_time
Sep 2025 to May 2026
Insurance verification Eligibility and benefit
AskVelma, full_time
Dec 2024 to Apr 2025
Insurance verification Eligibility and benefit Requesting prior-authorization Call and sending text messages to patients to collect out of pocket for their surgery.
MEDVA, full_time
Jul 2024 to Oct 2024
Insurance verification Eligibility and benefit Requesting prior-authorization Payment posting Submitting corrected claims, med-recs and appeals Account receivable / claims follow-up
KMC Mag Solutions, full_time
May 2023 to Jun 2024
Contact insurance carriers through website, email or telephone to resolve outstanding accounts. Analyze and resolve moderately complex insurance denials Appeal and/or resubmit unresolved invoices to insurance carriers. Research and respond to insurance correspondence. Update registration information, post denial codes and adjustments in practice management systems.
Conifer Health Solutions, full_time
Feb 2021 to May 2023
Research and obtain required documents to resolve misdirected payment issues. Contact insurance carriers through website, email or telephone to resolve outstanding accounts . Appeal and/or resubmit unresolved invoices to insurance carriers. Research and respond insurance correspondence. Analyze and resolve moderately complex insurance denials.
Access Healthcare Services, full_time
Aug 2019 to Feb 2021
Work assigned complicated Accounts Receivable accounts or high dollar denied claim accounts through the Access Healthcare or client’s workflow and follow up on claims with insurance companies Document in the revenue cycle system the actions taken, documentation sent to insurance companies, and any other notes from the call with the insurance companies with a view to decrease the days in A/R, optimize collections, and maintain a clear audit trail for future reference. Perform analysis accounts receivable data and understand the reasons for underpayment, days in A/R, top denial reasons, use appropriate codes to be used in for documentation of the reasons for denial/underpayments.
Optum Global Solutions, full_time
Jul 2017 to Aug 2019
Responsible for identifying recovery opportunity within the COB department. Review, research and process all COB claims for members with other insurance, including retractions, procedures, contractual requirements and other regulatory rules. Process and log all recoveries received from outside insurance companies. Responsible for phone calls to or from members, providers and other insurance companies to gather COB. Coordinate recoveries per federal regulations with other insurers for services unable to recovered
Access Healthcare Services, full_time
Apr 2016 to Jul 2017
Work assigned Accounts Receivable accounts and Access Healthcare or client’s workflow and follow up on claims with insurance companies. Document in the revenue cycle system the actions taken, documentation sent to insurance companies, and any other notes from the call with the insurance companies with a view to decrease the days in A/R, optimize collections, and maintain a clear audit trail for future reference. Perform analysis accounts receivable data and understand the reasons for underpayment, days in A/R, top denial reasons, use appropriate codes to be used in documentation of the reasons for denials/underpayments.