Tanya Hooper
Pasadena
Summary
Highly experienced professional with years of Customer Service skills. Hardworking with exceptional judgment, analytical and observation skills seeking a position with career advancement opportunities. Process the ability to build strong customer relations with the competence to verbally communicate in a multitasking environment. Excels at prioritizing , completing multiple tasks simultaneously, and following through to achieve project goals. Answers a high volume of incoming calls , while handling in-person inquiries from clients and colleagues. Exceptional attentiveness skills and familiarity with office machines (e.g. fax, printer etc.) Motivated to maintain customer satisfaction , reliable and driven, with strong time management skills. facilities. Seeking to establish a responsible though challenging position with opportunities for growth and advancement that will strengthen and utilize my customer service skills.
Friendly Insurance Verification Specialist promoting a background in keeping sensitive patient data confidential while maintaining knowledge of Medicaid and private policy benefits. Possessing great relationship building and communication skills. Looking to tackle new challenges with a company that values dynamic skills and a strong work ethic.
Skilled Insurance Verification Specialist with experience in verifying insurance coverage, understanding policies, and processing claims. Strengths include strong analytical skills, attention to detail, and ability to work under pressure. Proven record of improving efficiency in handling claims and enhancing customer satisfaction through timely resolution of disputes and issues.
Hands-on individual boasting a career spent managing administrative tasks in fast-paced offices with relative ease. A well-trained Insurance Verification Specialist offering a background in contacting insurance companies for critical information and crafting patient documents for billing purposes.
Self-motivated insurance verification specialist proudly offering several years' experience building an understanding of medical terminology while tracking patient coverage. A poised professional with benefits explanation and administration expertise. Offering time management and interpersonal skills.
Skilled administrative team member with in-depth understanding of medical standards, compliance requirements and operational procedures. Practiced problem-solver with friendly and caring mentality and excellent communication skills. Expertise in inventory management, customer service and inner-office operations.
Demonstrated knowledge of admissions, insurance verification and authorization processes in hospital and medical office settings.
Detail-focused Insurance Verification Specialist recognized for high productivity and efficient task completion. Specialize in insurance policy verification, claim processing accuracy, and patient data confidentiality management. Excel in communication, problem-solving, and time management to ensure seamless operations within healthcare settings.
Overview
16
16
years of professional experience
Work History
Insurance Verification Specialist
Luminis Health Imaging
Pasadena
03.2024 - Current
- Educated patients on their insurance benefits and coverage limitations.
- Liaised between physician, site of service and billing department to obtain appropriate documentation.
- Retained strong medical terminology understanding in effort to better comprehend procedures.
- Prepared and submitted detailed reports on insurance verification activities and outcomes.
- Communicated with insurance carrier, patient and third party or employer to verify patient insurance benefits.
- Developed a working knowledge of insurance plans, including Medicare and Medicaid regulations and requirements.
- Managed multiple tasks and priorities in a high-volume, fast-paced environment.
- Collaborated with internal staff members such as Billing Specialists, Medical Coders to resolve any discrepancies in patients' insurance information.
- Handled billing related activities focused on medical specialties.
- Accessed third-party insurance databases to identify coverage of benefits.
- Transcribed recorded practitioners' diagnoses and recommendations into medical records.
- Reviewed medical records to ensure accuracy of required information needed for pre-authorization requests.
- Routed laboratory or diagnostic results to appropriate staff.
- Responded promptly to customer inquiries regarding their benefits and eligibility status.
- Contacted patients to confirm demographic information and communicate financial responsibilities.
- Maintained confidentiality of patient information in accordance with HIPAA regulations.
- Monitored changes in government regulations affecting healthcare reimbursement systems.
- Liaised with insurance companies to obtain pre-authorizations for procedures and medications.
- Navigated through multiple online systems to obtain documentation.
- Determined estimated self-pay portion by calculating charges, co-insurance and deductibles.
Insurance Verification Specialist
Luminis Health Imaging
Pasadena
03.2024 - Current
- Collaborated with medical scientists to prepare reports, articles or conference presentations.
- Accessed third-party insurance databases to identify coverage of benefits.
- Handled billing related activities focused on medical specialties.
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
- Assisted physicians with finalizing reports, speeches or presentations.
- Updated patient accounts with insurance verification information to ensure accurate billing.
- Contacted patients to confirm demographic information and communicate financial responsibilities.
- Liaised with insurance companies to obtain pre-authorizations for procedures and medications.
- Managed multiple tasks and priorities in a high-volume, fast-paced environment.
- Implemented process improvements to enhance efficiency and accuracy of insurance verification.
- Completed relevant insurance and other claim forms.
- Communicated with patients with compassion while keeping medical information private.
- Routed laboratory or diagnostic results to appropriate staff.
- Developed and maintained professional relationships with insurance representatives.
- Navigated through multiple online systems to obtain documentation.
- Retained strong medical terminology understanding in effort to better comprehend procedures.
- Collaborated with internal staff members such as Billing Specialists, Medical Coders to resolve any discrepancies in patients' insurance information.
- Resolved insurance-related issues and discrepancies to prevent claim denials.
- Compiled and coded patient information or data in appropriate computer system.
- Prepared and submitted detailed reports on insurance verification activities and outcomes.
- Responded promptly to customer inquiries regarding their benefits and eligibility status.
- Ensured compliance with federal and state regulations regarding insurance verification.
- Verified patient eligibility for insurance coverage by contacting insurance carriers and obtaining the necessary authorization numbers.
- Evaluated policies and procedures related to Insurance Verification activities.
- Updated patient and insurance data and input changes into company computer system.
- Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
- Scheduled and confirmed patient appointments and consultations.
- Researched third party payer guidelines related to prior authorizations, coding and billing processes.
- Collaborated with multi-disciplinary staff to improve overall patient care and response times.
- Verified patient insurance coverage, benefits, and eligibility for services across multiple insurance platforms.
- Reviewed medical records to ensure accuracy of required information needed for pre-authorization requests.
- Liaised between physician, site of service and billing department to obtain appropriate documentation.
- Answered telephones and directed calls to appropriate medical or adminstrative staff.
- Monitored and tracked the status of pending insurance verifications and authorizations.
- Utilized electronic medical records (EMR) systems for documenting verification processes.
- Communicated with insurance carrier, patient and third party or employer to verify patient insurance benefits.
- Adhered to HIPAA requirements to safeguard patient confidentiality.
- Developed a working knowledge of insurance plans, including Medicare and Medicaid regulations and requirements.
- Maintained confidentiality of patient information in accordance with HIPAA regulations.
- Identified discrepancies in patient's insurance coverage or benefits, ensuring accuracy of data entered into system.
- Collaborated with healthcare providers to communicate insurance coverage and authorization details.
- Monitored changes in government regulations affecting healthcare reimbursement systems.
- Instructed clients on amounts covered under benefits plans in easy-to-understand terminology.
- Maintained accurate documentation on all pre-authorization requests, denials and appeals.
- Responded to patient inquiries regarding insurance coverage and billing issues.
- Educated patients on their insurance benefits and coverage limitations.
- Conducted follow-ups with insurance companies to expedite verification processes.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Maintained up-to-date knowledge of insurance policies, including Medicare and Medicaid.
- Provided timely follow up with payers regarding payment status of claims.
- Transmitted medical records and other correspondence by mail, e-mail, or fax.
- Participated in training sessions on new software programs used for verification purposes.
- Contributed innovative ideas and solutions to enhance team performance and outcomes.
- Identified needs of customers promptly and efficiently.
- Exceeded customer satisfaction by finding creative solutions to problems.
- Conducted comprehensive research and data analysis to support strategic planning and informed decision-making.
Orthopedic Patient Care Coordinator
Anne Arundel Medical Center / Luminis Health
10.2020 - Current
- Welcome patients by greeting them in person or on the telephone
- Verify patient information by interviewing patient, recording medical history and confirming purpose of visit
- Prepare patients for the health care visit by directing and/or accompanying them to the examining rooms
- Perform preliminary functions in the office such as faxing, coping, printing, and scanning paperwork
- Secure patient information and maintain patient confidence by completing and safeguarding medical records; completing diagnostic coding and procedure coding; keeping patient information confidential
- Counsel patients by transmitting physician's orders and questions about surgery
- Answer phone in a professional manner, voice mail and MyChart messages and route to providers as needed
- Do insurance authorizations to get approval's for CT scan and/or MRI
- Report to provider with all patient concern, questions and needs
Patient Care Tech II / CNA
Anne Arundel Medical Center
01.2009 - 10.2020
- Maintain a positive, empathetic and professional attitude toward patients at all times
- Respond promptly to patient inquiries
- Communicate with patients through various channels
- Acknowledge and resolve patients complaints
- Know companies products inside and out so that you can answer questions
- Process orders, forms, applications, and requests
- Keep records of patients interactions, transactions, comments and complaints
- Communicate and coordinate with colleagues as necessary
- Provide feedback on the efficiency of the customer service process
- Make beds, insert catheters, empty foleys, empty all drains post surgery
- Perform phlebotomy as needed
- Check to ensure all patients are safe every two hours
- Check vitals signs and blood glucose levels as needed
- Document all communication for the patient to the health care team in a timely manner
- Greet and attend to patients in person and over the phone
- Professionally assist doctors, staff, visitors and patients
- Maintain business inventory such as checking supplies, scheduling equipment and maintenance repairs
- Answer all phone calls in a professional and courteous manner
- Perform all duties within HIPAA regulations
- Maintain confidentiality of all doctor, staff and patient information
- Schedule appointments between doctors and patients
- Liaise between medical departments with discretion and professionalism
Education
High school diploma -
Annapolis Senior High school
Annapolis, MDSkills
- 100% on time record
- Commitment to career
- Efficiency
- Exude Professionalism
- Determination and Persistence
- Positive attitude
- Prompt followup
- Business Knowledge
- 85 WPM
- Interpersonal Skills
- Excellent interpersonal skills
- Detailed knowledge of company goals
- Products knowledge
- Services knowledge
- Creative thinking
- Analytical thinking
- Strong leadership skills
- Patience
- Calmness
- Interpersonal Communication
- Written Communication
- Verbal Communication
- Time Management
- Product Knowledge
- Telephone Etiquettes
- Vital signs observation
- Patient observation
- Hippa knowledge
- Patient privacy
- Strong work ethic
- Insurance verification
- Medical terminology
- Eligibility determination
- Pre-authorization management
- Patient communication
- Data entry accuracy
- Regulatory compliance
- Data entry
- Insurance authorization
- HIPAA compliance
- Multi-system navigation
- Customer service
- Problem solving
- Team collaboration
- Private insurance
- Data entry and review
- Insurance coverage verification
- Electronic medical records
- Insurance plan verification
- Attention to detail
- Follow-up procedures
- Coordination and scheduling
- Healthcare industry
- Prior authorization processing
- Data review
- Fraud prevention
- Workflow development
- Data entry proficiency
- Radiology
- Electronic authorization processing
- Skilled in [software]
- Document management
- Communication and interpersonal skills
- Insurance terminology
- Secure data practices
- Customer database systems
- Coverage and authorizations
- Proficient in [software]
References
Available upon request.
Key Qualifications
- 100% on time record.
- Commitment to career
- Efficiency
- Exude Professionalism
- Determination and Persistence
- Positive attitude, and prompt followup.
- Business Knowledge
- 85 WPM Interpersonal Skills
- Demonstrates excellent interpersonal skills.
- Possess detailed knowledge of company goals, products, and services.
- Exhibit ability to think creatively and analytically.
- Demonstrate strong leadership skills.
- Capable of remaining patient and calm when dealing with frustrated customers or patients
- Interpersonal Communication/Written and Verbal Communication
- Time Management
- Product Knowledge
- Telephone Etiquettes
- Vital signs and patient observation
- Hippa and patient privacy
- Strong work ethic
Timeline
Insurance Verification Specialist
Luminis Health Imaging
03.2024 - Current
Insurance Verification Specialist
Luminis Health Imaging
03.2024 - Current
Orthopedic Patient Care Coordinator
Anne Arundel Medical Center / Luminis Health
10.2020 - Current
Patient Care Tech II / CNA
Anne Arundel Medical Center
01.2009 - 10.2020
High school diploma -
Annapolis Senior High school