Insurance Representative Resume Sample

19 votes
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Sven Runolfsson
7272 Thiel Gardens,  Los Angeles,  CA
+1 (555) 633 2654

Work Experience

Senior Workers Compensation Insurance Representative
05/2016 - PRESENT
Phoenix, AZ
  • Experience in Medical/Hospital Insurance related collections
  • Licensed Life Insurance Agent (LLQP designation in Ontario)
  • Resolve questions/issues with customer’s insurance policies
  • Completes customer’s transactional requests
  • Completes customer’s transactional requests as provided by caller
  • Actively listens to customer issues or questions showing interest, compassion and displaying empathy for the caller’s situation
  • Acknowledge and direct customer’s requests for additional products or services to appropriate licensed representatives
Insurance Representative
09/2009 - 02/2016
Phoenix, AZ
  • Review EOB’s as necessary
  • Demonstrate and exemplify behavior consistent with DaVita’s core values – service excellence, integrity, team, continuous improvement, accountability, fulfillment, fun
  • Process patient account requests as needed
  • Utilizes telephone voice response systems and website solutions to obtain information on patients’ eligibility status with insurance companies
  • Works closely with referring physicians’ staff to obtain patient notes and begin process of authorizations
  • Collaborate with third party vendors to ensure Service Level Agreements are being met
  • Review and respond to email received from third party vendors and internal mortgage servicing functions and take necessary action to resolve documented issues pertaining to hazard insurance
Licensed Insurance Representative
02/2005 - 04/2009
Boston, MA
  • Conduct quality control exercises to ensure third party vendors are meeting their Service Level Agreements
  • Provide appropriate documents and information in support of audits being conducted by clients and investors
  • Complete Daily/Weekly/Monthly tasks/QC reports assigned
  • Ensure all regulatory deliverables are completed in the required timeline
  • Takes ownership and accountability of servicing customers
  • Effective in cultivating strong business relationships through a clear focus on internal and external customers
  • Able to overcome obstacles, be flexible and find common ground for resolution


Troy University - Colorado Springs/Ft. Carson
1999 - 2004
School's Degree in Healthcare

Professional Skills

  • Excellent organization, planning and prioritization skills
  • ) Strong communication skills with assertive touch
  • 2~3 years prior work experience including 1~2 years hospital billing or collection experience desired
  • Typing skills of 40wpm
  • Critical thinking skills, able to work independently
  • ) Customer service skills (retail or receptionist work)
  • Insurance experience, including customer service experience

How to write Insurance Representative Resume

Insurance Representative role is responsible for insurance, software, training, recruiting, auditing, planning, research, government, health, negotiation.
To write great resume for insurance representative job, your resume must include:

  • Your contact information
  • Work experience
  • Education
  • Skill listing

Contact Information For Insurance Representative Resume

The section contact information is important in your insurance representative resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:

  • First and last name
  • Email
  • Telephone number

Work Experience in Your Insurance Representative Resume

The section work experience is an essential part of your insurance representative resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous insurance representative responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular insurance representative position you're applying to. The work experience section should be the detailed summary of your latest 3 or 4 positions.

Representative Insurance Representative resume experience can include:

  • Completes all of the pre-service activities to include, but not limited to, preregistration, order validation, insurance coverage verification; obtains pre-authorization and completes payment collection
  • Prove oral/written communication skills
  • Effectively process third-party payer and patient over payments
  • ) Strong research experience
  • Looking for candidates with previous reinsurance claims experience or working on the primary insurer side of processing claims
  • Experience with insurance billing in an office setting required

Education on an Insurance Representative Resume

Make sure to make education a priority on your insurance representative resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your insurance representative experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.

Additional details to include:

  • School you graduated from
  • Major/ minor
  • Year of graduation
  • Location of school

These are the four additional pieces of information you should mention when listing your education on your resume.

Professional Skills in Insurance Representative Resume

When listing skills on your insurance representative resume, remember always to be honest about your level of ability. Include the Skills section after experience.

Present the most important skills in your resume, there's a list of typical insurance representative skills:

  • Very good English skills, good knowledge of Norwegian (min. B2)
  • ) Strong organization skills to process certified mail and match documents to be sent out by underwriters
  • Ensure deposits balance to posting and resolve any discrepancies; effectively process third-party payer and patient overpayments
  • Strong ability to quickly assess and offer effective solutions to problems efficiently
  • Analytical, interpersonal, and communication skills
  • This is not a call center. Limited phone skills required.

List of Typical Experience For an Insurance Representative Resume


Experience For Senior Workers Compensation Insurance Representative Resume

  • Assists with payment status, maintains department status reports and logs. Investigates referral denials. Acts as a liaison between physician, hospital personnel and selected payors
  • Experience with Insurance Liability
  • Ensure accurate account information in all billing areas; obtain correct information and update system when billing information is incorrect or missing
  • Coordinates and completes insurance referral processing system following department protocols
  • Works with testing departments, physicians and their staff to collect data for Utilization Review. Works with specialist physician assuring adequate information flow between specialist and referring PCP

Experience For Bilingual Onsite Insurance Representative Resume

  • Responds to patient and third party inquiries regarding accounts, insurance changes, billing procedures, etc. in person or over the phone
  • Answers telephone in a pleasant and professional manner, identifying department and name
  • Assists clinic staff in resolving issues related to self-pay, past-due and collection accounts
  • Completes new physician certification and physician recertification paperwork for insurance carriers according to deadlines
  • Adheres to clinic and departmental policies and procedures including patient confidentiality

Experience For Licensed Insurance Representative Resume

  • Responsible for coordinating the collection of insurance information from all athletes, which includes the yearly mailings to parents
  • Responsible for all medical bills that maybe outstanding and follow-up payment of bills in a timely manner to avoid medical collections
  • Provide the Athletic Trainer with a report of the action on outstanding medical bills. Responsible for all medical records related to athletes
  • Insurance Representative is responsible for superior customer service while working with patients
  • Ensures completion and accuracy of data, paperwork, and/or forms

Experience For Customer Insurance Representative Resume

  • Ensures accuracy of information and runs reports as needed
  • Collects, enters, updates, and/or corrects patient demographic and insurance information as necessary
  • Checks databases and other sources to verify patient insurance coverage
  • Investigates denials, and completes miscellaneous forms and prior authorizations; writes letters and appeals; and provides copies of records, EOBs, or other information to patients or insurance carriers to resolve claims or patient balances
  • Reviews and monitors outstanding insurance balances
  • Reviews medical records to clarify information and answer questions
  • Knowledge of spreadsheets and databases
  • Accurately and timely post private payments, insurance payments, disallows and/or denials to appropriate patient account, calculate patient responsibility, interpret explanation of benefit message codes; identify payment discrepancies by contacting insurance carrier; and determine if re-bill is necessary

Experience For Auto / Property Insurance Representative Resume

  • Trace errors, record adjustments to proper accounts, and determine the appropriate destination for unidentified funds
  • Initiate claims for billing to secondary insurance companies for coordination of benefits; resolve unidentifiable payments from agencies in an appropriate manner
  • General knowledge of the department''s operations and objectives desirable
  • Reviews and monitors all total loss, repair or gap claims on a daily basis
  • Initiates contact with customers or agencies through outbound calls in an effort to negotiate payments or to satisfy any deficiency balances
  • Makes recommendations to file lien holders’ claims or repossess to ensure all possible recovery efforts are evaluated
  • Properly document all account activity in the computer system
  • Ensure compliance with policies and procedures with the Fair Debt Collection Practices Act

Experience For Workers Compensation Insurance Representative Resume

  • Responsible for all pre-certification and referrals from primary care physicians of all medical procedures needed by athletes
  • Coordinate appointments for all athletes with physicians or medical providers
  • Coordinate all medical procedures with the family primary insurance when applicable
  • Liaison between parents of athletes to explain work related insurance procedures
  • Responsible for explanation of benefits for all procedures
  • Prepare all purchase orders and Internal Requisitions for the payment of medical procedures
  • Insurance Representative makes outbound calls to insurance companies to verify benefits coverage, copays, etc

Experience For Imaging Insurance Representative Resume

  • ) Dependable and motivated
  • ) Personal lines insurance is helpful but not required
  • Post private payments, insurance payments, disallows and/or denials to appropriate patient accounts
  • Trace errors, record adjustments to proper accounts and determine the appropriate destination for unidentified funds
  • Resolve unidentifiable payments from agencies in an appropriate manner

Experience For Healthcare Insurance Representative Resume

  • Comprehensive knowledge of CPT and ICD9 codes
  • Comprehensive knowledge of CPT and ICD10 codes
  • Sort and file materials correctly by alphabetic and numeric system
  • Opens, stamps and distributes mail
  • Codes, groups and forwards forms
  • Collates and copies; reviews files, documents and printouts

Experience For Insurance Representative Bariatric Clinic Resume

  • Provide customer service both face to face and electronically
  • Determine insurance eligibility for all referrals through direct payer call and/or electronic means and chart accordingly per SOP’s
  • Work with all 3rd party payers to determine coverage requirements and confirm that the referral meets or does not meet that payer’s coverage requirements
  • ) Admin/receptionist background
  • ) Customer Service oriented
  • Dependability, attention to details,and ability to follow/interpret procedures

Experience For Hospital Insurance Representative Resume

  • ) Attention to detail
  • This team is a Legal team
  • Data entry/computer savvy
  • Flexible on hours
  • 8 hours a day
  • No remote work

List of Typical Skills For an Insurance Representative Resume


Skills For Senior Workers Compensation Insurance Representative Resume

  • Experience reviewing and processing documents and procedures
  • One year of experience working in a hospital, physician office or clinic setting required
  • Insurance Representative is responsible for checking insurance benefits for patients and conducting prior-authorization
  • Experience following up on insurance questions regarding benefits, coverage, etc
  • Open to different professional backgrounds, looking for someone who wants to get their foot in the door. No insurance experience required

Skills For Bilingual Onsite Insurance Representative Resume

  • One to two years medical authorization or billing experience
  • Take direction from manager, manage multiple tasks and conflicting priorities
  • Customer service and/or administrative experience
  • Previous personal lines insurance experience (insurance license is great, not required PNC)
  • Work with the insured to provide excellent customer service

Skills For Licensed Insurance Representative Resume

  • Candidates with solid, continual work history are highly desirable
  • Demonstrated knowledge of managed care principles, insurance industry practices, and medical terminology required
  • Operate data entry equipment and related computer systems
  • Three to five years of healthcare experience required
  • Six months of medical office experience required
  • ) Experience in high production and repetitive environment
  • Work with MD Office to initiate and obtain Prior Authorization if required as per DaVita Rx SOP’s
  • Assists in investigation of denials as necessary to obtain appropriate payment or prioritizes retro-authorization requests
  • Responsible for obtaining approval of all medical procedures prior to payment of bills

Skills For Customer Insurance Representative Resume

  • Maintain effective working relationships with physicians, staff, patients, other healthcare facilities, service providers, and general public
  • 10-key calculator and telephone experience
  • Experience with superior customer service
  • Administrative experience within the healthcare field
  • Assisting in the assessment of client needs by reviewing current policies and formulating recommendations for different types of policies
  • Participating in the analysis of clients’ existing insurance programs and requirements
  • Assisting team members with the preparation of proposal presentations for existing and prospective clients

Skills For Auto / Property Insurance Representative Resume

  • Working knowledge of basic arithmetic
  • Ensure accurate account information in all billing areas and updates the system when billing information is incorrect or missing
  • Insurance Representative is responsible for updating patient accounts with registration, insurance, demographic, scheduling, and billing data
  • Make sound judgements independently while knowing when to bring situations to the attention of Management
  • Process confirmations including policy number posting as needed

Skills For Workers Compensation Insurance Representative Resume

  • Critical thinking and attention to detail is required in reviewing signed, legal documents
  • General knowledge of bookkeeping, basic accounting, and familiarity with insurance industry practices
  • Determine patient benefits including financial responsibility and chart accordingly in Operating System per SOP’s
  • Assist in analyzing geographies, products, customer/distribution channels, pricing/profitability models
  • Handles phone inquiries as well as trouble shooting directly with patients, payors, physicians, medical office staff and testing departments
  • Responsible for obtaining and transferring the primary care physician coverage of athlete's home to a primary care physician in the Miami area

Skills For Imaging Insurance Representative Resume

  • Proficiency using multiple websites and accessing insurance payer portals
  • ) Ability to multitask/computer savvy – working within multiple systems
  • ) Open to hiring previous employees
  • Able to work standard office equipment, including PC keyboard and mouse, copy/fax machines, and printers
  • Able to sit for extended periods of time and periodically move about during the work day

Skills For Healthcare Insurance Representative Resume

  • Hospital in Hartford looking for Insurance Representative to join their team as soon as possible
  • Performs basic clerical functions not requiring specialized knowledge of systems and procedures
  • Audit charges to ensure accurate procedure codes, billing data and patient information is submitted
  • Initiate claims for billing to secondary insurance companies for coordination of benefits
  • Ensure deposits balance to posting and resolves any discrepancies
  • NOT interested in candidates who have processed billing or claims in a Doctor''s office
  • Obtains continuing authorizations as needed

Skills For Insurance Representative Bariatric Clinic Resume

  • Analysis of data and compiling research through the use of spreadsheets, company databases and other computer systems
  • 440 or 220 Required
  • Possess an upbeat, positive and enthusiastic attitude
  • Be able to obtain or currently possess a property & casualty insurance license
  • Ablility to communicate verbally and written
  • ) Basic Administrative Assistant

Skills For Hospital Insurance Representative Resume

  • Production based environment, so candidates need to be comfortable in a fast paced environment
  • ) Familiarity with Excel and Word, Adobe preferably
  • Dependability, attention to details, and ability to follow/interpret procedures. Requirements: Knowledge of administrative procedures and software applications (such as Microsoft Office Word, Excel, PowerPoint, etc.)
  • Flexible spending accounts (FSA)​
  • Medical, Dental, Vision, Life and Long Term Disability Insurance
  • Strong communication and negotiation skills, both written and verbal, delivering clear and concise messages and at all times promoting and enhancing the client brand
  • ) Experience with high volume work
  • Complete random confirmations assigned through programmed random IWrite verbal process within guidelines
  • Work to resolved confirmation discrepancies

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