Aleiha Talford
Lancaster,South Carolina
Summary
Resourceful Specialist offering expertise in problem-solving, data analysis and customer service. Adept at quickly learning new technologies and processes for driving success. Proven track record of successfully managing multiple projects and developing innovative solutions.
Overview
6
6
years of professional experience
Work History
Reimbursement Specialist
CareMetx
12.2023 - Current
- Streamlined reimbursement processes by implementing efficient filing and tracking systems.
- Improved departmental accuracy through meticulous attention to detail while reviewing claims submissions.
- Ensured timely payment of claims by promptly addressing and resolving any discrepancies or issues with insurance providers.
- Contributed to increased team productivity by consistently meeting or exceeding individual processing goals.
Quality Fax Specialist
The Lash Group
07.2022 - 02.2023
- Ensured necessary documents and notation was entered into the company CRM system accurately and in a timely manner
- Reviewed agent fax interactions to assure agents are following company scripts and protocol to assure customer satisfaction
- Monitored general Quality Assurance for e-mail correspondence and responded to agents emails
- Monitored QA procedures for adherence by employees, notifying personnel of non-compliance issues
- Contributed to business growth by confirming customer satisfaction with service and quality
- Updated daily audit scores on shared excel sheet.
Patient Access Specialist
The Lash Group
05.2018 - 07.2022
- Verified insurance coverage and obtained necessary authorizations to ensure timely billing and reimbursement.
- Reduced claim resolution time by improving communication between departments and prioritizing urgent cases.
- Managed high-volume claim caseloads, ensuring accurate documentation and adherence to company policies.
Benefits Verification Specialist
Lash Group
11.2017 - 05.2018
- Compiles medical insurance verification of benefit and eligibility information submitted by client for processing within contracted timelines
- Ensures verification of benefit and eligibility information obtained from payer/insurance company is accurate
- Inability to obtain a verification of benefit or incomplete information is reported to the manager immediately
Education
Medical Assistant -
Southeastern Institute
10.2011
High School Diploma -
Great Falls High School
01.2003
Skills
- Root Cause Analysis
- Emergency Response
- Customer Relations
- Supply Management
- Quality Assurance
- Proficient in [Software]
- Documentation Management
- Performance monitoring
- Critical thinking
- Decision making
- Customer service
- Creative thinking
Timeline
Reimbursement Specialist
CareMetx
12.2023 - Current
Quality Fax Specialist
The Lash Group
07.2022 - 02.2023
Patient Access Specialist
The Lash Group
05.2018 - 07.2022
Benefits Verification Specialist
Lash Group
11.2017 - 05.2018
Medical Assistant -
Southeastern Institute
High School Diploma -
Great Falls High School