Hospital insurance representative skills for your resume and career

Updated January 8, 2025

1 min read

Below we've compiled a list of the most critical hospital insurance representative skills. We ranked the top skills for hospital insurance representatives based on the percentage of resumes they appeared on. For example, 32.2% of hospital insurance representative resumes contained hmo as a skill. Continue reading to find out what skills a hospital insurance representative needs to be successful in the workplace.

4 hospital insurance representative skills for your resume and career

1. HMO

Here's how hospital insurance representatives use hmo:

Follow up with Insurance on outstanding accounts including HMO, PPO, MC, MD, W/C and COMM carriers.
Manage all billing accounts including Medicare/Medicaid, HMO and individual accounts.

2. Medical Terminology

Here's how hospital insurance representatives use medical terminology:

Translated medical terminology and abbreviations into expanded forms to ensure the accuracy of patient and health care facility records.
Enter claims data into system while interpreting coding and understanding medical terminology in relation to the diagnosis and procedures.

3. EOB

EOB stands for explanation of benefits. This is a common outline provided as part of many health insurance plans to explain what services were completed, the co-pay required for each appointment, and how much of your payment is covered by health insurance. EOB is an indication that your insurance claim has already been processed.

Here's how hospital insurance representatives use eob:

Reviewed explanation of benefits (EOB) documentation for primary and secondary billing criteria and problem resolution.
Researched detailed account disputes and billing discrepancies through EOB s and completed account/payment reconciliations.

4. CPT

CPT is a medical term that stands for Current Procedural Terminology. Whenever a procedure like surgery or diagnosis occurs or some other medical service is rendered to a patient, it is reported to the concerned physician, insurance company, or organization. The aforementioned practice is widely referred to as CPT.

Here's how hospital insurance representatives use cpt:

Assure the correct documentation reflected in chart related to assigned ICD-9 CM diagnosis, CPT, and modifiers.
Interact closely with Medical Providers, Insurance Providers and Medical Coders to clarify diagnosis and CPT information.

What skills help Hospital Insurance Representatives find jobs?

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List of hospital insurance representative skills to add to your resume

The most important skills for a hospital insurance representative resume and required skills for a hospital insurance representative to have include:

HMO
Medical Terminology

Updated January 8, 2025

Zippia Team

Editorial Staff

The Zippia Research Team has spent countless hours reviewing resumes, job postings, and government data to determine what goes into getting a job in each phase of life. Professional writers and data scientists comprise the Zippia Research Team.

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Hospital Insurance Representative Skills

Updated January 8, 2025

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