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Insurance Coordinator Resume Sample

This resume is a sample for the post of Insurance Coordinator. Insurance is a department that requires accuracy and good character qualities. An Insurance coordinator’s job is a strict one as he has to coordinate, manage and arrange different tasks related to the insurance department. Now the question arises how you can write a good and impressive resume for Insurance Coordinator? There are certain specific tips for writing a good resume. You should keep in mind them before starting your resume.

Guidance About Writing Insurance Coordinator Resume Sample:

The resume for this post must be proper. It must entails all of your capabilities along with highlighting your good moral character. It must manifest that you are able to work under pressure and a multiple task manager. (You may want to see Insurance Executive Resume Sample, Health Insurance Manager Resume Sample for better understanding and ideas). Below we have given you an example of such a resume that should help you to create an impressive resume. Finally adding (verified) references to your resume is definitely going to add to the worth of your resume.

Name :   XYZ

Email: xxxxxx@xxxx.com

Place:  Al Qasmia, Sharjah, UAE

Contact No :  0000000

CAREER OBJECTIVE:

To serve the organization better with integrity, honesty and confidence; to make use of the opportunities and facilities for the development of organizational and individual goals; and ensure better performance with my technical and managerial skills.

EDUCATIONAL QUALIFICATION:

  • Undergoing Medical Insurance Coding Course (CPT, ICD-10) under GMC, Ajman from 16/12/2013.
  • Master’s in Hospital Administration from Amrita School of Arts and Science with 89% aggregate.
  • Graduation in Economics with 78%aggregate
  • Plus Two in Commerce with 75% aggregate
  • PG Diploma in Human Resources and Marketing from IGNOU.
  • IELTS scored with band 7.

SOFTWARE PROFICIENCY:

  • Operating System: MS DOS, Windows 98, 2000, XP
  • Social Media Awareness.

PROFESSIONAL EXPERIENCE:

Sl.no Organisation Place Position Period
1 Pharmalink Group (Medicina) Sharjah, UAE Insurance Coordinator 2014
2 International Radiology Center Sharjah, UAE Insurance Coordinator 2013
3 KIMS Hospital & Surgical Center Cochin, India Insurance Coordinator 2011
4 Lakeshore Hospital and Research Center Ltd, Cochin Cochin, India Insurance Executive 2009
5 Amrita Institute of Medical Sciences and Research Centre Cochin, India Admin & Insurance Executive 2007

 JOB PROFILE – PHARMALINK GROUP (MEDICINA PHARMACIES), SHARJAH, UAE

  • Supervise, manage and monitor claims submission and re submission to ensure accuracy and processing insurance claims in timely approach.
  • Review and monitor denial reasons and discrepancies, processed claims to minimized revenue loss and maximize reimbursement.
  • Processed claim forms, adjudicates for provision of deductibles, co-pays, co-insurance maximums and provider settlements.
  • Entered claims online for authorization request (PBM Link, E-Rx, Openjet) and coordinating with Dimensions healthcare for HAAD regulation rules and changes.
  • Entered claims data into system, reviewed and made sure that there is no omitted information, Entered claims into computer utilizing knowledge of CPT, ICD codes and medical terminology.
  • Create a detailed summary report of filled claims for each month and keep tract of the payments, reconciliation, discrepancies and denials for reporting and filling purposes.
  • Checking and review all claims we received from all our branches in Abu Dhabi, Dubai and Northern Emirates. Segregating Claims per facility, per insurance and per TPA.
  • Filing all submitted claims and duplicate of paper claims for audit purposes and re submission for our reference if in-case there is a denial.
  • Performing as a liaison between insurance company’s and provider concerning network agreements, enrollment of the New Pharmacies open and contract renewal.
  • Assist and conduct a training for the new hired Pharmacists regarding insurance policies and the claims department staff in carrying out their duties effectively
  • Inform the pharmacist about new circular received from the insurance companies and new insurance network added in our company
  • Answered inquiries from providers (Pharmacies) on the subject of claim, eligibility, covered benefits, insurance inclusion, exclusions and approval status issues

JOB PROFILE – INTERNATIONAL RADIOLOGY CENTRE, SHARJAH, UAE:

  • Attend Insurance customers in the Clinic.
  • Obtain authorizations from respective Insurance providers for Healthcare services in the clinic.
  • Maintain files and records of all insurance cases.
  • Attend to the customer queries related to Health Insurance.
  • Prepare monthly and weekly and Quarterly MIS of the department.
  • Responsible for assisting patients with the processing of insurance claims and coordinating with insurance companies and TPAs for getting the required claims approval and keeping its proper record. Contacts insurance companies and patients regarding outstanding balances. Researches and resolves insurance billing issues.
  • Assists and reviews claims and E-claims pre and post submission to determine completeness, accuracy and collection of unpaid and denied claims.
  • Facilitate the processing of unpaid and denied claims and receipt of payments from insurance companies.
  • Examine remittance advice to ensure the collection of applicable third party reimbursements.
  • Determine the reason for denied claims and resubmits or follow up with insurance companies to propriety and medical necessity of services by the facility.
  • Verifies new patients insurances and re-verifies that of patients coming back on service.
  • Submits pre-determinations for clinical medical necessity.
  • Review all claims for accuracy.
  • Works closely with Patient Relations Manager, Customers Care Representatives, Nursing Staff, Insurance Manager and providers to ensure claims accuracy and processing.
  • Completes proper tracking and reporting for Finance Department regarding collection and error rates.
  • Interact with insurance companies to research and resolve complex claims billing problems/issues.
  • Prepare, and/or maintain reports on billing and collection activities.
  • Establish working relationships with insurance carriers and third party payers
  • Enters data into the computer as needed
  • Maintains frequent phone contact with case managers at third party insurance companies.
  • Participate and contribute to departmental quality initiatives.
  • Perform any job/task as and when assigned by the superior.

JOB PROFILE IN ORGANISATION’S INDIA:

  • Coordinating, liaising and networking between insurance companies regarding eligibility, payments, approvals, reconciliation and other requirements.
  • Taking approvals from Insurance Companies for Inpatient procedures
  • Responsible for filing and tracking insurance claims and informing patients of their claims status.
  • Process insurance and disability claims in a timely manner.
  • Prepares insurance forms and associated correspondences.
  • Dealing with all the famous health insurance companies.
  • Rejected claims to be rectified by providing the requirements needed by the insurance company.
  • Collecting deduction and co insurance from insurance patient.
  • Develop good relationship with various insurance companies.
  • Preparation of IP Insurance Bills.
  • Taking prior approval for lab investigations and other procedures, in case required as per the agreement with the Insurance companies.
  • Giving clarifications to the concerned person in Insurance companies regarding the sent claims.
  • Entertains patients’ queries regarding unpaid balances.
  • Liaise with patients regarding their eligibility and entitlements.
  • Corporate marketing – emplacement of corporate for various medical services
  • Coordinating camps, workshops, awareness programs, exhibitions etc.
  • Internal marketing which includes conducting different programs for employees especially for nurse’s day, special packages for employee referrals.
  • Assists with the development and administration of various departmental programs and prepares reports.
  • Processes invoices and other miscellaneous payments for the department.
  • Responds to department inquiries (mail, phone, email)
  • Develop and maintain good working relationships with all relevant local governmental bureaus, agencies and authorities
  • Interacting with customers, senior-level executives, and all other levels of employees.
  • Provide general administrative support including but not limited to: phones, distributing mail, and preparing expense reports.
  • Organize and maintain file and records.
  • Media Activities – press release, events etc.
  • Preparing monthly and annual reports
  • Day to day operations
  • Inviting International patients from UAE, Oman, Nigeria etc. for treatment.
  • Communicating with international agencies for referrals of patients.
  • Transportation arrangements for the patients.
  • Providing necessary help for the patient for their stay, OP consultation, admissions etc.
  • Make the patients aware about the hospital policies and procedures and also providing financial information to the patients.
  • Handling of Corporate, Executive checkups etc.
  • Administering the day to day operations of the department.
  • Handling insurance related activities.

MAJOR ACHIEVEMENTS in KIMS Hospital:

  • Corporate Tie ups: Tied up with Apollo Tyros, Binani Zinc Limited, Carborundum (CUMI), Cognizant Technologies, UST Global Services, Idea Cellular Limited, State Bank of Travancore, Corporation bank, SUDchemie, Ultratech Cements, Najath School, SCMS College, Aries Telecasting Limited.
  • Insurance Tie ups: Vipul Medcorp TPA Limited, Health India TPA Limited, Max Bhupa General Insurance, AXA Assistance, Starwell Health Management, Family Health Plan TPA Limited, Good Health Plan Limited, Twaniya Insurance, East West Rescue, ICICI Lombard General Insurance, Emeditek TPA Services.

MAJOR ACHIEVEMENTS in Lakeshore:

  • Corporate tie up: Tied up with Indian Oil Corporation, Air India, RBI, Canara Bank
  • Insurance Tie ups: Vipul Medcorp TPA Limited, Health India TPA Limited, Starwell Health Management.

PERSONAL SKILLS:

Comprehensive problem solving abilities, organizing and coordinating skills, good verbal and written communication skills, ability to deal with people, willingness to work in a team, work under pressure.

PERSONAL PROFILE:

Name                                   :        xyz

Husband’s Name                     :        xyz

Nationality                              :        Indian

Date of Birth                          :        22.2.1982

Marital Status                         :        Married

Passport No                            :        00000

Visa Status                            :        Husband Visa

Visa Expiry                             :        21.02.2016

License                                  :        UAE Driving License

Hobbies                                 :        Reading, Traveling, Hearing Music

Languages Known                   :        Malayalam, English, and Hindi

Reference:
Mr. ABC
Sales Manager,
International Radiology Center,