Carol Royder
Somerville
Summary
Detail-oriented Denials Specialist with extensive experience in eligibility assessment and appeals processing. Proven track record in streamlining processes and enhancing accuracy in Medicaid compliance.
Overview
21
21
years of professional experience
Work History
Denials Specialist
Conifer Health Solutions
Remote
10.2008 - Current
- Assessed denial patterns to provide insights for implementing effective corrective measures.
- Engaged with internal teams to identify and resolve claims discrepancies, ensuring streamlined processes and improved accuracy.
- Developed instructional materials focused on best practices in denial management to support staff training initiatives.
- Ensured adherence to regulatory guidelines and company policies through consistent monitoring.
Patient Access Representative
CHI St. Joseph College Station Urgent Care
College Station, TX
01.2005 - 08.2009
- Facilitated efficient patient check-in operations, prioritizing accurate data collection and verification.
- Streamlined insurance verification processes to enhance efficiency in patient billing procedures.
- Facilitated communication between patients and healthcare providers to optimize service delivery.
- Optimized appointment scheduling processes to enhance operational efficiency.
Education
High School Diploma -
Snook Hight School
Snook TXAssociate of Arts - Elementary Education
Lee College
Baytown, TXSkills
- Eligibility assessment
- Medicaid compliance knowledge
- Appeals processing
- ICD-10 proficiency
Timeline
Denials Specialist
Conifer Health Solutions
10.2008 - Current
Patient Access Representative
CHI St. Joseph College Station Urgent Care
01.2005 - 08.2009
High School Diploma -
Snook Hight School
Associate of Arts - Elementary Education
Lee College