Aylesha Hallman
Severn
Summary
Personal Qualifications: Professional with strong experience in reimbursement processes and healthcare administration. Proven ability to manage complex billing systems, ensure compliance, and maximize revenue recovery. Valued for team collaboration, adaptability, and achieving measurable results. Skills include claims processing, coding, payer relations, and problem-solving. Reliable and responsive to evolving needs in fast-paced environments.
Knowledgeable Reimbursement Specialist with solid history in managing complex reimbursement processes and resolving billing issues. Efficiently handled claims and appeals, ensuring compliance with regulatory requirements and minimizing denials. Demonstrated analytical skills and attention to detail in optimizing reimbursement strategies.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Reimbursement Specialist
Maxim Healthcare
11.2023 - Current
- Reviewed and processed insurance claims to ensure compliance with reimbursement policies.
- Analyzed billing discrepancies, facilitating timely resolution and enhancing cash flow management.
- Collaborated with healthcare providers to verify patient eligibility and coverage details.
- Developed and maintained accurate documentation for reimbursement processes and audits.
- Maintained comprehensive knowledge of healthcare billing practices, staying current on industry updates and changes in regulations.
- Contributed to increased team productivity by consistently meeting or exceeding individual processing goals.
- Coordinated with insurance providers to verify customer's policy benefits in relation to claims.
- Maintained patient confidentiality by adhering to strict HIPAA guidelines when handling sensitive information.
- Ensured timely payment of claims by promptly addressing and resolving any discrepancies or issues with insurance providers.
- Prevented delays and claim denials by correcting information prior to submission.
- Followed up on denied and unpaid claims to resolve problems and obtain payments.
- Assisted patients with understanding their benefits coverage, providing clear explanations regarding out-of-pocket expenses and reimbursements.
- Developed a reputation for expertise in handling complex reimbursement cases, becoming a go-to resource within the team for assistance in problem-solving difficult scenarios.
- Processed vendor and supplier payments on weekly basis.
- Monitored outstanding invoices and performed collections duties.
- Handled accounts with past due balances and documented each account.
- Responded to concerns and questions on daily basis.
- Collaborated with my offices to resolve any discrepancies.
- Kept vendor files accurate and up-to-date to expedite payment processing.
Credit and Collections Representative
Comcast
08.2017 - 11.2023
- Demonstrates functional skill to troubleshoot and resolve technical problems and other general account inquiries over the phone in a single customer interaction to maximize the customer experience, with demonstrated ability to articulate relevant information and directions in an organized and concise manner.
- Follow established troubleshooting procedures, including use of appropriate resources and desktop tools. When necessary, produce work order according to established business rules.
- Demonstrated ability to establish and maintain effective relationships with customers. Effectively gains the customer's cooperation to work through the troubleshooting process, ensuring customer problem resolution.
- Corrects discrepancies on customers' accounts, and researches service disruptions as necessary. When appropriate, follow established escalation procedures to expedite prompt resolution.
- Begins to act as a product consultant, articulating product features and benefits and making recommendations based on customer needs/interests; identifying buying signals and asking for the sale, reselling current value or right-size, delivering a quality customer experience.
- Demonstrates functional skill in communicating and explaining basic account information to the customer with focus on first-call resolution.
- Ability to multitask between multiple tools and systems (knowledge base, team meetings, supervisor) and apply information and knowledge to customer situations.
- Demonstrates awareness of company policies and procedures while applying sound judgment within scope of their empowerment and follows guidelines for Customer Proprietary Network Information (CPNI) and Personal Identifiable Information (PII).
- Educates and promotes self service options.
- Fundamental understanding of competitive environment and begins to position Comcast's products positively to our customers.
- Must be able to work in a fast-paced, structured, dynamic and high- transaction environment, with the ability to maintain composure in stressful situations and manage and diffuse angry or upset customers.
- Demonstrates ability to achieve established goals and performance metrics.
- Regular, consistent and punctual attendance. Must be able to work nights and weekends, variable schedule(s) and overtime as necessary.
- Attends training as required.
- Works independently and seeks Supervisor support when necessary.
- Supports other lines of business as volumes dictate.
- Other duties and responsibilities as assigned.
- Interacts with customers via telephone, e-mail, or face-to-face to assist with a variety of customer inquiries and issues. Must be able to wear telephone headset and manipulate objects such as pen, keyboard, and mouse.
- Managed high-volume collections inquiries, ensuring timely resolution of customer account issues.
- Developed and implemented strategies to improve collection processes, enhancing overall efficiency.
Warehouse Associate
Office Depot
04.2023 - 08.2023
- Unload and sort trailer
- Maintained clean and organized work areas to enhance safety and efficiency.
- Sort the boxes to the assigned route to pallets
- Load the delivery trucks
- Separate route depending work loads for each driver
- Shrink wrap and label any pallets going to different routes
- Clean my work station
- Operated forklifts and pallet jacks to efficiently move inventory within warehouse.
- Conducted regular inventory audits to ensure accuracy and minimize discrepancies.
- Worked safely around moving machinery.
- Consistently lifted materials weighing as much as 50 pounds.
- Consistently met or exceeded productivity targets while maintaining high standards for quality and safety.
Machine Operator/Forklift Operator
The Washington Post
10.2013 - 04.2018
- Responsibilities:
- Set up machines at the beginning of shift to ensure proper working order
- Perform testing procedures to ensure that the machines are working during the production procedures
- Maintain and clean machines before and after each shift
- Feed product into the machine according to shapes and sizes through the machine set up box
- Replace or adjust pieces on the machines when needed
- Calibrate machines at the beginning of each shift
- Recalibrate machines at the end of each shift
- Monitor machines during every procedure to ensure optimum running
- Troubleshoot problems during machine operation
- Ensure that regular and preventative maintenance procedures are carried out
- Perform random tests to ensure accuracy
- Perform safety checks on every machine
- Ensure that machines are producing quality products by managing periodic checks on output
- Ensure stocks of needed materials are ready and available at all times Create and maintain activity logs
- Provide relevant information regarding progress to supervisors
- Maintained a clean work area
- Assisted others when they needed
- Maintained the quality control area
- Stacked bundles of newspapers when needed
Equipment Manager, Merchandiser
City Sports
11.2013 - 05.2015
- Responsibilities
- Help sale our products to customers
- Up sell products
- Keep the store clean and Organized
- Tackle any specialty projects given by the store manager in a timely manner
- Answer the phones
- Keep the store stocked
- Greet customers
- Merchandise the store every week
- Markdown Merchandise according to the systems updates
- Assist in any department ( men, women, equipment, shoes, front register etc.)
- Provide excellent customer service
- Assist the store manager with day to day activities.
Assistant Store Manager
The Fudgery
11.2013 - 11.2014
- Operate/ balance out all cash registers throughout the day
- Prepare and sale all products on the daily prep list
- Make sure the display cage is neat and clean and presentable to the public
- Stock all items that are in the store
- Provide excellent customer service
- Scan all delivery invoices and send them to the home office
- Make sure all staff stayed on task and on schedule
- Make all store orders for products and any extra items
Security Officer
National Security Patrol
08.2013 - 10.2013
- Patrolled and Secured parking lot during school at Bishop McNamara High School
- Patrolled and secured areas during outdoor sporting events and after school actives
Dog Daycare Attendant
Potomac Dog School
05.2013 - 08.2013
- Watched dogs while in play areas inside/outside
- Feed dogs while in boarding area
- Issued medication to dogs
- Bathe and groomed dogs
- Drove shuttle bus to pick up/deliver dogs
Warehouse Worker
Aerotek Staffing Agency
09.2012 - 08.2013
- Scanned incoming/outgoing products
- Packed products for store orders
- Keep the warehouse neat and clean
Sales Associate/Junior Clinic Administrator
Message Envy Spa
11.2011 - 09.2012
- Answer the telephones
- Provide excellent customer service
- Stock & front face shelves
- Book appointments
- Keep supplies stocked in spa area
- File and maintain customer records via scanning them into the computer or file cabinet.
- Keep front end and message areas clean and neat
Security Officer
Watergate at Landmark Security
05.2010 - 03.2011
- Answering the Telephones in Communications
- Patrolling the community on foot or vehicle
- Taking reports
- Typing the daily logs
- Performing lock-out procedures
- Booting/Towing any vehicles in violation of the rules and regulations
- Writing violation tickets
- Hand delivered important mail to residents on property
- Performed routine checks around the property
- Lock/unlock doors at given hours
- Provide excellent customer service
Cashier/Pet Trainer
Petsmart Inc
10.2008 - 05.2010
- Answer the telephones
- Booked appointments for the grooming salon
- Certified Pet Trainer (I train Dogs of all ages and sizes)
- Worked in the Fish, small animal, and cat departments
- Worked as a cashier when needed
- Stocked and front faced the shelves
- Provided customer service to all customers
Box Office Clerk/Park Ranger/HR Assistant
Department of Interior
05.2003 - 09.2008
- Box Office Clerk:
- Sold tickets for concerts, accepting cash and credit cards
- Issue will call tickets to customers printed from Ticket Master Machines
- Balanced out cash drawer at end of shift
- Provide a high level of customer service
- HR Assistant:
- Assist with day to day operations of the HR functions and duties
- Provide clerical and administrative support to Human Resources executives
- Update employee records (hard and soft copies)
- Process documentation and prepare reports relating to personnel activities (staffing, recruitment, training, and performance evaluations)
- Deal with employee requests regarding human resources issues, rules, and regulations
- Assist in payroll preparation by providing relevant data (absences, bonus and leave request)
- Communicate with public services when necessary
- Properly handle complaints procedures
- Conduct initial orientation to newly hired employees
- Park Service:
- Provide private and group tours to visitors
- Designing and implementing park lectures for schools and other community or social groups
- Prepare exhibits and information materials
- Developing conservation programs
- Leading nature tours
- Studying wildlife behavior
- Monitoring air and water quality
Education
Criminal Justice -
PG Community College
Largo, MD01.2008
High School Diploma - Business Finance
Potomac High School
Oxon Hill, MD01.2005
Skills
- Forklift Operator (4 years)
- Microsoft Office (10 years)
- Outlook (10 years)
- Microsoft Excel (10 years)
- Microsoft Powerpoint (5 years)
- Payroll (3 years)
- Administrative Assistant (9 years)
- Call Center (6 years)
- Customer Service (10 years)
- Customer Care (6 years)
- Customer Support (6 years)
- Dog Training (4 years)
- Animal Care (4 years)
- Pet Care (4 years)
- Pet Grooming (3 years)
- Security (3 years)
- Employee Orientation
- Pet Sitting (8 years)
- Kennel Experience (3 years)
- Management (6 years)
- Laboratory Experience
- Veterinary Assistant (3 years)
- Dog Handling (4 years)
- Typing (6 years)
- Appeals handling
- HCPCS coding
- Claims processing
- Insurance verification
- Copay collection
- Eligibility verification
- Teamwork
- Problem-solving
- Attention to detail
- Multitasking Abilities
- Time management
- Reliability
- Organizational skills
- Adaptability and flexibility
- Verbal and written communication
- Active listening
- Cash handling
- Task prioritization
- Self motivation
- Billing and invoicing
- Computer literacy
Accomplishments
- Resolved product issue through consumer testing.
Certification
Forklift Certification
Timeline
Reimbursement Specialist
Maxim Healthcare
11.2023 - Current
Warehouse Associate
Office Depot
04.2023 - 08.2023
Credit and Collections Representative
Comcast
08.2017 - 11.2023
Equipment Manager, Merchandiser
City Sports
11.2013 - 05.2015
Assistant Store Manager
The Fudgery
11.2013 - 11.2014
Machine Operator/Forklift Operator
The Washington Post
10.2013 - 04.2018
Security Officer
National Security Patrol
08.2013 - 10.2013
Dog Daycare Attendant
Potomac Dog School
05.2013 - 08.2013
Warehouse Worker
Aerotek Staffing Agency
09.2012 - 08.2013
Sales Associate/Junior Clinic Administrator
Message Envy Spa
11.2011 - 09.2012
Security Officer
Watergate at Landmark Security
05.2010 - 03.2011
Cashier/Pet Trainer
Petsmart Inc
10.2008 - 05.2010
Box Office Clerk/Park Ranger/HR Assistant
Department of Interior
05.2003 - 09.2008
High School Diploma - Business Finance
Potomac High School
Criminal Justice -
PG Community College
Additional Information
Skills: Proficient in Microsoft Word, Word Perfect, Microsoft Power Point, Excel. I am able to access and browse e-mail notification/internet. I am able to operate a scanner. I am able to type 50 words per minute.
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