Health Insurance Specialist Resume

A health insurance specialist handles the tasks of examining and reviewing insurance claims of clients to determine whether the claims are covered in the insurance policies. The person work with medical facility or insurance companies and keeps records of patients. He may also be trained to perform medical coding and process medical insurance claims. The job holder is also proficient in interpreting laws and regulations relating to health insurance and rejecting or accepting medical insurance claims.

Health Insurance Specialist Resume Example

---

Kenneth R. Viers
276 Smithfield Avenue
Amarillo, TX 79101
Phone: 806-680-6669
Email: krviers@example.com

Career Objective:

To work with a leading medical facility as a health insurance specialist and performing medical coding and filing of medical insurance claims for patients.

Summary of Skills:

• Comprehensive knowledge of insurance regulations, processes and guidelines
• Extensive knowledge of medical billing, health claims and processing insurance claims
• In-depth knowledge of medical coding and medical terminology
• Familiar with major computer applications and the Internet
• Possess sound oral and written communication skills
• Skilled in handling multiple task and has the ability to work under pressure

Work Experience:

Health Insurance Specialist
Pearl Health System, Amarillo, TX
October 2014 - Present

• Assisting insurance providers for the purpose of verifying eligibility of insurance claims and processing claims
• Determining the insurance coverage and payable claim amount
• Answering questions on processing insurance claims, insurance coverage and billing procedures
• Planning and coordinating employee benefit plans like maintenance of records, benefit payment, administrative expenditures, and other related matters
• Monitoring filing of unemployment claims as well as files appropriate response to the state for claims
• Preparing quarterly unemployment tax payments as well as performing audit of quarterly benefit statements

Health Insurance Specialist
Sentry Medical System, Amarillo, TX
February 2013 - September 2014

• Reviewed patient records and medical insurance claims and determined eligibility
• Assisted patients by explaining insurance benefits and available resources
• Educated patients regarding availability of alternative insurance options
• Answered patients' questions on insurance coverage plans and filing claims
• Prepared and maintained patient insurance information in the data system and coordinated with insurance companies
• Assisted in filing legal suit against companies denying genuine medical claims

Education:

• Bachelor's Degree in Accounting
  Amarillo University, Amarillo, TX
  2011

• Certification in Health Insurance Program
  ABC Technical School, Amarillo, TX
  2012

Reference:

On request.