Summary
Overview
Work History
Education
Skills
Timeline
Generic

Alicia Tate

Clayton

Summary

With experience as a Benefits Verification Specialist at CVS Healthcare and a Charge Analyst at FastMed Corp, I bring expertise in insurance management, pharmacy benefits coordination, revenue cycle analysis, and medical billing compliance.

In my previous roles, I achieved a 15% reduction in billing errors through accurate charge validation and adherence to coding standards. I excel at collaborating with clinical teams and payers to resolve benefit issues, troubleshoot claims, and ensure timely patient access to care.

I would welcome the opportunity to bring my skills and experience to your company and support your team’s success.

Overview

9
9
years of professional experience

Work History

Benefits Verification Specialist

CVS Healthcare
02.2020 - Current
  • Performed insurance benefit verifications for both medical and pharmacy coverage to confirm patient eligibility and out-of-pocket costs.
  • Submitted and obtained prior authorizations from insurance carriers to ensure timely patient access to medications and treatments.
  • Troubleshot claim rejections by reviewing coverage details, correcting errors, and resubmitting for approval.
  • Conducted monthly benefit re-verifications to maintain accurate records and prevent disruptions in patient therapy.
  • Partnered with Accounts Receivable and billing teams to resolve benefit discrepancies and support proper reimbursement.
  • Delivered exceptional patient support by explaining insurance coverage, pharmacy benefits, and prior authorization outcomes in a clear, patient-friendly manner.

Charge Entry Analyst

FastMed
05.2016 - 02.2020
  • Reviewed and validated medical charges against documentation, improving charge accuracy and reducing billing errors by 15%.
  • Ensured compliance with CMS, UB-04, EOBs, HCPCS, CPT, and ICD coding, which decreased claim denials and improved reimbursement turnaround times.
  • Partnered with clinical, coding, and billing teams to resolve discrepancies and payer rejections, resulting in faster resolution of outstanding claims.
  • Conducted charge reconciliation and audits, identifying trends that led to workflow improvements within the revenue cycle process.
  • Prepared and analyzed financial and charge reports to support leadership in revenue cycle management and strategic decision-making.
  • Maintained strict adherence to HIPAA and compliance standards, while multitasking effectively in a fast-paced, high-volume corporate environment.

Education

Medical Office Assistant

ECPI University
Raleigh, NC
06-2017

Skills

  • Insurance & Benefits Management: Benefit verification for major medical and pharmacy plans, prior authorizations, monthly re-verifications, claim troubleshooting
  • Revenue Cycle & Charge Analysis: Charge reconciliation, coding validation (HCPCS, CPT, ICD), denial management, EOB/UB-04 review, and payer compliance
  • Pharmacy & Medical Knowledge: Pharmacy benefits coordination, medical necessity reviews, durable medical equipment and supply billing
  • Collaboration & Problem-Solving: Partnering with Accounts Receivable, clinical staff, and payers to resolve discrepancies and ensure timely reimbursement
  • Technical Proficiency: Epic EMR, CMS systems, and medical billing platforms with strong reporting and auditing skills
  • Regulatory Compliance: In-depth understanding of HIPAA guidelines, CMS policies, and insurance payer requirements
  • Professional Strengths: Multitasking, accuracy under deadlines, adaptability in fast-paced environments, and clear communication with patients and providers

Timeline

Benefits Verification Specialist

CVS Healthcare
02.2020 - Current

Charge Entry Analyst

FastMed
05.2016 - 02.2020

Medical Office Assistant

ECPI University

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Alicia Tate