Aisha Bouhairie
Allen
Summary
Courteous Denial Specialist with over 1 year of hands-on experience processing healthcare disputes and reviewing cases to determine facts of each case. Patient and helpful professional well-versed in reading and interpreting medical records and formulating clinical appeals and letters. Commended for superb conflict resolution skills and calm approach while dealing with irate clients. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
17
17
years of professional experience
Work History
Denial Specialist
Baylor Scott & White Medical Center
10.2022 - Current
- Collaborated with billing department staff to ensure accurate coding and charge entry, minimizing future claim denials.
- Maintained up-to-date knowledge of industry trends and best practices in denial management, ensuring the organization''s processes remained competitive and effective.
- Notified insurance agents and accounting departments of policy cancellations and changes.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Maintained knowledge of insurance coverage benefit levels, eligibility systems and verification processes.
- Provide all necessary documentation required to resolve claim denial.
- Report any payer reimbursement trends and denials.
- Contacting insurance companies to validate denials and make sure appeals are timely processed.
- Review A/R after the appeal is processed to make sure the claim is paid in full.
- Conduct follow-up with payers and vendors on open insurance claims.
- Posted payments to accounts and maintained records.
Health Unit Coordinator
Baylor Scott & White Medical Center
08.2009 - 10.2022
- Enhanced communication between medical staff by promptly answering phone calls, relaying messages, and responding to inquiries.
- Assembled and maintained patient medical records and other documents related to patient care.
- Ensured patient safety through strict adherence to HIPAA regulations and maintaining confidentiality of sensitive information.
- Reduced wait times for patients by effectively managing patient flow within the health unit.
- Coordinated successful discharges from the facility by liaising with other departments and ensuring necessary paperwork was completed promptly.
- Transcribed physician orders accurately and alerted nurses to new orders, single orders and stat medications.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Communicated with patients, ensuring that medical information was kept private.
- Responded to patient call lights to expedite appropriate follow-through.
- Assisted with processing patient admissions, transfers and discharges.
- Maintained accurate patient records through diligent data entry and timely updates in the electronic health record system.
- Excellent communication skills, both verbal and written.
Patient Care Technician
Baylor Scott & White Medical Center
05.2007 - 08.2009
- Cared for clients with diagnoses such as respiratory failure, diabetes, Parkinson's disease and muscular dystrophy.
- Obtained patient vital signs and reported results to staff nurse or physician, noting changes from prior measurements.
- Maintained clean and safe environment to promote patient safety and comfort.
- Participated in ongoing professional development opportunities to stay current on best practices in patient care technology advancements.
Education
Associate of Science - Health Sciences
St. Monicas College
No Degree -
Greyson College
I’m A Licensed Independent Adjuster
Skills
- Document Control
- Denied claims identification
- Insurance Verification
- Denial Management
- Claims analysis
- Medical Coding
- Organizing and Prioritizing Work
- Medical Billing
- Understanding of medical terms
- Medical Terminology
Timeline
Denial Specialist
Baylor Scott & White Medical Center
10.2022 - Current
Health Unit Coordinator
Baylor Scott & White Medical Center
08.2009 - 10.2022
Patient Care Technician
Baylor Scott & White Medical Center
05.2007 - 08.2009
Associate of Science - Health Sciences
St. Monicas College
No Degree -
Greyson College
I’m A Licensed Independent Adjuster