Efficient Reimbursement Specialist with solid background proactively managing claims and preventing insurance issues. Competent in keeping records accurate and current and proactively managing account problems. Excellent customer relations skills combined with analytical approach to handling routine and complex delays.
Work History
Revenue Cycle Specialist
2 Months
Neuhaus Foot And Ankle | 08.2026 - Current
Managed insurance verification and eligibility checks for patient accounts.
Submitted clean claims and corrected rejections to support faster reimbursement.
Analyzed denial trends and resolved claim issues through payer follow-up.
Posted payments, adjustments, and contractual write-offs with accuracy.
Reviewed EOBs and patient balances to maintain compliant billing workflows.
Monitored aging accounts receivable and pursued outstanding balances with patients and payers.
Increased revenue by identifying and resolving billing errors in a timely manner.
Enhanced customer satisfaction by promptly addressing and resolving billing disputes.
Reached out to insurance companies to verify coverage.
Coordinated patient payment plans, balancing compassion with firmness to ensure timely payments while preserving positive patient relationships.
Maximized reimbursements by staying current on payer requirements and maintaining strong relationships with insurance providers.
Balanced and reconciled accounts.
Improved cash flow with diligent follow-up on pending claims and appeals processes.
Reduced outstanding account balances by implementing effective collection strategies.
Grievance Coordinator Remote
1 Year 4 Months
HCSC - Blue Cross Blue Shield of Illinois | 03.2025 - 07.2026
Managed grievance and appeal cases, ensuring accurate documentation and timely resolution.
Reviewed member complaints, claims details, and plan provisions to support compliant determinations.
Coordinated with clinical, claims, and customer service teams to gather case information.
Drafted clear correspondence outlining grievance outcomes and next-step guidance.
Monitored case queues to maintain consistency, workflow prioritization, and service quality.
Grievance Coordinator
1 Year 1 Month
Cigna | 02.2024 - 03.2025
Coordinated grievance and appeal case workflows, ensuring timely resolution and compliance with plan requirements.
Reviewed member complaints, claim details, and supporting records to determine appropriate handling and next steps.
Documented case activity accurately in internal systems, maintaining complete records for audit readiness.
Interpreted regulatory and plan guidelines to support consistent grievance processing and compliant outcomes.
Collaborated with clinical, claims, and customer service teams to gather information and resolve complex cases.
Communicated resolution status and required documentation to members, providers, and internal stakeholders.
Identified recurring grievance trends and recommended process improvements to strengthen operational efficiency.
Account Installation Senior Representative Remote
7 Months
Cigna Healthcare | 07.2023 - 02.2024
Resolved complex member inquiries regarding benefits, claims, and eligibility with accurate, compliant guidance.
Coordinated case follow-up across internal teams to support timely service resolution and documentation.
Interpreted plan provisions, provider information, and policy details to deliver consistent account support.
Tracked service requests in workflow systems, ensuring complete notes and accurate record updates.