Medical Insurance Specialist Resume

Posted in Specialist Resume Examples

Edgar Simmons

37 Gambler Lane

Houston, TX 77077



Job Objective Seeking work as a Medical Insurance Specialist so I can use my skills and past experiences to better the company. Bringing specialized knowledge to the table to also improve your company with my skills

Highlights of Qualifications:

  • Admirable experience in developing and executing various pharmaceutical manufacturer programs
  • Sound knowledge of billing and verification processes
  • Deep knowledge of Medicare billing process
  • Immense ability to train subordinate staff
  • Exceptional ability to evaluate all coverage requirement
  • Amazing computer system skills
  • Skilled in ICD-9 and CPT-4 coding

Professional Experience:

Medical Insurance Specialist

Programs, Inc., Houston, TX

May 2006 – Present

  • Evaluated various coverage requirements for current and prospective customers.
  • Documented all communication with insurance carriers and prospective and present customers.
  • Supervised efficient working of personnel within required timeframe.
  • Coordinated with public and employees in an appropriate manner.

Medical Insurance Specialist

Gonzaba Medical Group, Houston, TX

March 2003 – April 2006

  • Monitored request for payments and managed all communication with patients.
  • Administered and resolved all guarantor payments and resolved all discrepancies.
  • Managed reimbursement claims and ensured payments according to contract terms.
  • Evaluated all denied claims by coordinating with payer and appeal process.


Bachelor’s Degree in Business Administration

Sacramento City College, Sacramento, CA

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