Brenda Seger
Deale
Summary
Detail-oriented Medical Insurance Specialist with ICD-10 proficiency and a strong focus on procedure authorizations and referrals as well as ensuring HIPAA compliance and fostering excellent customer relationships.
Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.
Overview
19
19
years of professional experience
Work History
Medical Insurance Specialist
Capitol Cardiology Associates
Greenbelt, MD
10.2006 - Current
- Verified insurance eligibility and benefits for patients, ensuring accurate coverage information.
- Collaborated with healthcare providers to resolve discrepancies in billing and coding practices.
- Trained junior staff on insurance verification processes and customer service techniques.
- Contributed to positive relationships with insurance companies through consistent follow-up and prompt issue resolution.
- Reduced claim denials by verifying patient eligibility and coverage details prior to submission.
- Achieved timely resolution of claim issues through effective communication with insurance carriers and healthcare providers.
- Provided exceptional customer service, assisting patients in understanding their insurance benefits and financial responsibilities.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Reviewed provider coding information to report services and verify correctness.
- Responded to correspondence from insurance companies.
- Processed insurance payments and maintained accurate documentation of payments.
- Obtaining Prior authorizations
- Patient appointment scheduling
- Answering provider phone lines
Education
High School Diploma -
Bowie High School
Bowie, MDSkills
- ICD-10 proficiency
- Appeals handling
- HIPAA compliance
- Patient confidentiality
- Claims processing
- Insurance verification
- Payment posting
- Private insurance policies
- Medical coding
- Customer service
- Insurance claims processing
- Medical terminology
- Critical Decision-making
- Knowledgeable in IMS,Instamed, Outlook and Microsoft Office
- Telephone etiquette
- Healthcare billing
- ICD codes
- Problem-solving
- Time management
- Multitasking
- Excellent communication
Timeline
Medical Insurance Specialist
Capitol Cardiology Associates
10.2006 - Current
High School Diploma -
Bowie High School