Chelsey Evans
Healthcare Professional
Augusta,Georgia
Summary
Compassionate healthcare professional with over 6 years of experience in patient services, insurance coordination, and claims support. Skilled in high-volume environments handling communication with patients, providers, and insurers. Proficient in outpatient scheduling, clinical documentation review, and verifying insurance and demographic information in compliance with HIPAA. Proven ability to multitask using systems such as Epic, Oracle, Salesforce, Excel, and Outlook while ensuring a positive patient experience.
Overview
7
7
years of professional experience
2
2
years of post-secondary education
Work History
RCM Denials Specialist
Highmark Health
10.2022 - Current
- Verified patient insurance and demographic details, contributing to a 98% clean claim rate through accurate submissions.
- Maintained 100% HIPAA compliance while processing and correcting claim data in high-volume environments.
- Achieved monthly zero AR balance by resolving outstanding claims and coordinating with providers and payers for follow-ups.
- Utilized Epic and payer portals to update claims with clinical information, improving turnaround time by 20%.
Appeals & Claims Coordinator
ExamWorks
08.2020 - 10.2022
- Verified insurance, demographic, and clinical information for 150+ appeals monthly, ensuring documentation accuracy and accelerating claims processing.
- Communicated with providers and patients via Outlook and phone, contributing to a 90% successful appeal resolution rate by securing timely and complete submissions.
- Tracked and organized appeals workflow in Excel, reducing processing delays by 25% through consistent follow-up and status checks.
- Applied knowledge of radiology procedures and terminology to identify discrepancies and ensure appropriate coding for appeal support.
Billing & Insurance Representative
Teleperformance
06.2018 - 08.2020
- Resolved 60+ patient inquiries daily regarding medications, orders, and billing in a high-volume environment, consistently meeting call quality standards and minimizing escalations through clear, empathetic communication.
- Verified patient insurance coverage and coordinated with providers to ensure accurate billing and reimbursement.
- Scheduled medication reorders, followed up on delivery concerns, and maintained timely updates in Salesforce CRM.
- Adhered to HIPAA guidelines while documenting interactions, which helped reduce claim rework by 15%.
Education
Associate Degree - Medical Billing & Coding
Miller Motte College
Augusta, GA 08.2019 - 05.2021
Skills
- Outpatient Scheduling
- Pre-Registration
- Insurance Verification
- High Call Volume
- Patient Communication
- Radiology Familiarity
- Clinical Documentation Familiarity
- Microsoft Excel, Word, Outlook
- EMR Platforms (Epic, Oracle)
- CRM Systems (Salesforce)
- Citrix
- HIPAA Compliance
- Remote Work Productivity
Timeline
RCM Denials Specialist
Highmark Health
10.2022 - Current
Appeals & Claims Coordinator
ExamWorks
08.2020 - 10.2022
Associate Degree - Medical Billing & Coding
Miller Motte College
08.2019 - 05.2021
Billing & Insurance Representative
Teleperformance
06.2018 - 08.2020
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