Alice Davis
Medical Healthcare Manager
Dallas,TX
Summary
Experienced Medical Billing and Collections Manager with over 20 years of expertise in healthcare revenue cycle management. Proven track record of optimizing billing operations, improving collections performance, and leading high-performing teams. Adept at navigating insurance claims, regulatory compliance, and patient account resolution. Now seeking to bring my skills, leadership, and dedication to excellence to a dynamic organization where I can make a meaningful impact.
Overview
13
13
years of professional experience
Work History
Claims Analyst
UnitedHealthcare
Dallas
01.2019 - Current
- Issue Letter of Agreement (LOA) to the facility after the rate has been negotiated
- Managed Long-term Care professional liability claims from first notice through resolution, including investigation, coverage determination, liability and damages evaluation, reserve setting, settlement negotiation, and file closure within assigned authority.
- Conducted complex coverage analysis involving duty to defend vs. indemnify, occurrence vs. claims made policies; allocation issues, additional insured status, contractual liability, tail coverage, and policy endorsements; drafted clear coverage opinions and reservation of rights/declination letters.
- Maintained comprehensive claim documentation within the Claims Management System, proactively diarizing critical follow-ups, statutory deadlines, and litigation milestones.
- Investigated and assessed damage to property and reviewed property damage estimates.
- Worked with private investigators and attorneys on preparation of evidence, witness statements, and other documentation in preparation for trial.
- Identified suspicious losses and contacted manager for investigative assistance.
Senior Medical Billing Manager
PLUTUS/CAPTION BILLING
Dallas
12.2018 - 12.2019
- Supervised a team of billing specialists to ensure accurate claims processing.
Senior Medical Biller
DIGESTIVE HEALTH ASSOCIATE BILLING GROUP
Dallas
12.2015 - 12.2018
Billing/Collector Lead
CLAIMCARE MEDICAL BILLING GROUP
01.2013 - 12.2015
- Follow up, correct, appeal and/or re-submit corrected claims to payers.
- Investigate, respond to correspondence and requests from insurance carriers, sites and patients.
- Review and work aged balance report upon receipt.
- Making all negotiated adjustments.
- Verifying payable diagnosis with Code-link and McKesson.
- Updated customer files with issued invoices, processed payments, and new account information.
- Processed invoices and updated billing information accurately and efficiently.
- Reviewed clinical statements and assigned standard codes using CPT, ICD-10-CM, or HCPCS Level II.
- Daily responsibilities include but are not limited to working claim rejections.
- Gateway, uploading electronic payments, submitting electronic claims.
- Denials, appeals, daily correspondence, and negotiation with payer.
- Weekly meetings with providers to go over collections, billing, and goals.
- Assist staff with any assistance needed.
- Assisted in achieving department's collection goals.
- Communicated with attorneys regarding litigation cases involving overdue accounts.
Education
BBA - Business Administration And Management
Mansfield Business School
Dallas, TX 06.1989 - 01/1992
High School Diploma - High School Basics
H.G. Spruce High School
Dallas, TXSkills
- ECW
- NEXTGEN PRACTICE
- WAYSTAR
- ATHENA
- EPIC
- CENTRICITY
- EMR
References
Upon request
Timeline
Claims Analyst
UnitedHealthcare
01.2019 - Current
Senior Medical Billing Manager
PLUTUS/CAPTION BILLING
12.2018 - 12.2019
Senior Medical Biller
DIGESTIVE HEALTH ASSOCIATE BILLING GROUP
12.2015 - 12.2018
Billing/Collector Lead
CLAIMCARE MEDICAL BILLING GROUP
01.2013 - 12.2015
BBA - Business Administration And Management
Mansfield Business School
06.1989 - 01/1992
High School Diploma - High School Basics
H.G. Spruce High School