Healthcare professional with hands-on experience in Revenue Cycle Management (RCM), insurance verification, and collections within a high-volume BPO healthcare environment (BCBS MN account). Experienced in handling commercial, Medicaid, and state-funded insurance plans with strong knowledge of eligibility, benefits verification, and payer guidelines. Skilled in resolving billing-related inquiries, managing financial responsibility details, and supporting end-to-end revenue cycle processes including collections and account follow-ups. Detail-oriented, efficient, and able to work independently in fast-paced, KPI-driven environments.
CORE SKILLS
-Insurance Eligibility & Benefits Verification (Commercial, Medicaid, State Plans)
-Revenue Cycle Management (RCM) Support
-Medical Collections & Accounts Follow-Up
-Patient Financial Responsibility (Copay, Deductible, Coinsurance)
-Insurance Web Portals Navigation
-Claim Support & Basic Denials Handling
-Healthcare Customer Service (Payer-side experience)
-Data Entry & Documentation Accuracy
-HIPAA Compliance Awareness
-Google Workspace & MS Office
EXPERIENCE HIGHLIGHTS
- Handled insurance verification and member eligibility through BCBS MN payer systems and portals
- Supported revenue cycle workflows including coverage validation and financial responsibility breakdown
- Managed insurance-related inquiries and assisted in resolving billing and coverage concerns
- Experienced in collections support processes and account status updates in healthcare setting
- Worked with Medicaid and state-funded insurance programs alongside commercial plans
- Maintained accurate documentation in CRM and internal tracking systems under strict deadlines
TECHNICAL TOOLS
-Insurance Web Portals (payer systems)
-CRM / Healthcare support tools
Microsoft Excel, Word, Outlook
-Google Sheets, Google Drive, Google Docs
STRENGTHS
-Fast learner with ability to adapt to new healthcare systems and workflows
-Strong attention to detail in financial and insurance data
-Comfortable handling sensitive patient information
-Reliable in KPI-driven and high-volume environments
Experience: Less than 6 months
Accurately inputted medical and insurance data into multiple software platforms with attention to detail.
Experience: 2 - 5 years
Reviewed insurance claims, identified denial reasons, and followed up with providers for resolution.
Experience: 2 - 5 years
Reviewed denied claims, identified reasons for denials, and followed up with providers or insurance companies to resolve issues efficiently.
Experience: 2 - 5 years
Managed professional correspondence with clients, providers, and insurance companies, ensuring timely responses and clear communication.
Experience: 2 - 5 years
Prepared and maintained accurate records of claims, denials, and billing activities, generating reports to track workflow and performance.
Experience: 2 - 5 years
Accurately inputted medical and insurance data into multiple software platforms with attention to detail.
Experience: Less than 6 months
Verified patient insurance details and eligibility, ensuring accurate billing and smooth claims processing.
Experience: Less than 6 months
Communicated with clients, providers, and insurance companies to resolve inquiries and maintain positive relationships.
Experience: 2 - 5 years
Created and managed spreadsheets for claims tracking, billing data, and reporting
Experience: 2 - 5 years
Handled daily administrative tasks including data management, document preparation, and communication.
Experience: 2 - 5 years
Organized documents and emails efficiently using Google Workspace.
“They're not only loyal and hardworking, they're super detail oriented!”
- Travis OVAAnswers
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