Chaniqua Ousley
Mansfield
Summary
Experienced Health Insurance Specialist successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering 9 years of experience and willingness to take on any challenge.
Overview
10
10
years of professional experience
Work History
Billing Specialist/Payment Posting Specialist
Caregiver Services Inc.
10.2023 - Current
- Process and submit claims to Medicare and Medicaid
- Maintain 97% clean claim rate through careful review and validation
- Investigate and resolve claim denials, resulting in 30% reduction in denial rate
- Handle patient billing inquiries and resolve discrepancies
- Monitor accounts receivable aging and follow up on outstanding claims
- Post payments from insurance carriers and patients with 99.9% accuracy
- Process EOBs and ERAs for multiple provider accounts
- Reconcile payment variances and identify underpayments
- Research and resolve payment discrepancies
- Generate daily/weekly/monthly payment reports
Accounts Receivable and Billing Specialist
Accupro Services
03.2022 - 10.2023
- Maintained a solid balance of health insurance claims that are 35 average days outstanding.
- Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
- Managed accounts receivable process for clients accounts, including billing, collections, and cash application
- Responded to customer inquiries and resolved billing and payment issues to maintain timely and accurate account balances
- Identified daily billing errors and corrected and resubmitted via adjustment or new submission
- Responded to attorney inquiries and litigation notices.
- Used mediation techniques to facilitate communication between disputants, to further parties' understanding of different perspectives and to guide parties toward mutual agreement.
- Monitored, tracked, and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
- Built strong relationships with clients to deliver emotional support and companionship.
Accounts Receivable Specialist/Appeals Specialist
Parallon/HCA
07.2015 - 03.2022
- Contacted insurance carriers, bill review companies, and other related organizations in order to process medical claims
- Researched, followed up, and resolved all open/pending issues in a timely manner
- Identified daily billing errors and corrected and resubmitted via adjustment or new submission
- Followed up on denied medical claims.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Developed appeals functions, policies and procedures and documentation.
- Created, composed and maintained appeal response templates.
- Monitored, tracked, and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
Education
Associates -
Tarrant County College
Fort Worth, TX05.2015
High School Diploma -
Crowley High School
Crowley, TX05.2010
Skills
- Proficient in Microsoft Programs
- Strong attention to detail and organizational skills
- Account analysis and reporting
- Collections and account reconciliation
- Ability to multitask and self-prioritize
- Strong Written and oral Communication Skills
- Customer Service Support
- Insurance Claim Forms Review
- Correspondence Writing
- Billing systems and software
- Invoice Processing
- HIPAA Compliance
Timeline
Billing Specialist/Payment Posting Specialist
Caregiver Services Inc.
10.2023 - Current
Accounts Receivable and Billing Specialist
Accupro Services
03.2022 - 10.2023
Accounts Receivable Specialist/Appeals Specialist
Parallon/HCA
07.2015 - 03.2022
High School Diploma -
Crowley High School
Associates -
Tarrant County College
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