Cindy Chery
Denials & AR Analyst
Port Saint Lucie,FL
Summary
A knowledgeable, highly-motivated and creative problem solver with 12 years of healthcare experience. Strong work ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Well-versed in policies, procedures, and standards.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Denial Analyst
R1 Rcm
Chicago, IL
07.2023 - Current
- Reviewed denied claims for potential resubmission or reconsideration..
- Investigated and documented payment errors resulting from incorrect processing of claims.
- Advised providers on coding changes required for accurate reimbursement.
- Reviewed documents for accuracy and completeness prior to processing appeals.
- Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
- Analyzed and evaluated appeals to ensure compliance with applicable laws, regulations, policies and procedures.
- Compiled and documented information for appeal cases.
- Evaluated medical records to ensure accuracy of diagnoses and treatments.
Care Coordinator and Appeals Specialist
Whole Family Health Center
Vero Beach, FL
09.2020 - Current
- Monthly follow up calls to ensure patients’ health and safety
- Linking patients to social services programs and entitlements such as transportation assistance, housing assistance and translation services
- Write appeals using established guidelines to resolve claim denials with a goal of one contact resolution
- Identified reasons behind denied claims and worked closely with insurance carriers to promote resolutions
- Creating and updating personalized care plans for patients
- Gathered and verified insurance requirements to meet payer requirements
- Assisted patients by answering questions and providing information regarding referrals
- Managed and obtained insurance authorizations for patient referrals from physicians.
Medical Assistant/Referral Coordinator
Midway Primary Care
Fort Pierce, FL
10.2016 - 10.2020
- Answering and routing calls, filing, paperwork and calling patients to remind them of upcoming appointments
- Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment
- Conducted insurance verification and pre-certification and pre-authorization functions
- Reviewed referral details and expectations with providers and patients and requested new referrals when necessary
- Secured patient information and maintained patient confidence by completing and safeguarding medical records
- Measured vital signs and took medical histories to prepare patients for examination
- Prepared treatment rooms for patients by cleaning surfaces and restocking supplies.
Appeals and Collection Specialist
Advanced Healthcare for Women
Stuart, FL
11.2011 - 10.2016
- Research patient accounts
- Identified reasons behind denied claims and worked closely with insurance carriers to promote resolutions
- Write appeals using established guidelines to resolve claim denials with a goal of one contact resolution
- Identified and resolved denied, non-paid claims and billing issues due to coverage issues, medical record request and authorizations
- Checked documentation for appropriate coding, catching errors and making revisions
- Follow up on claim rejections and denials to ensure appropriate reimbursements
- Transcribed data to worksheets and entered data into computer to prepare documents and adjust accounts
- Handled billing related activities focused on medical specialties.
Education
Associate of Applied Arts - Medical Assisting
Adult Education of Vero Beach
11.2012
Skills
- Team Collaboration
- Verbal and Written Communication
- Interpersonal skills
- Time Management
- Decision Making
- Critical Thinking
- Strong Ethics
- Multitasking and Organization
- Information Verification
- Appeals
- Collection
- Problem-Solving
- Calm Under Pressure
- Insurance Precertification Processes
- Conflict Mediation
- Root Cause Analysis
- Information Gathering
- Issue Identification
- Account Reconciliation
- Analytical Thinking
- Complex Mathematics
- Claims Evaluation
- Investigation Management
- Claims Investigation
- Policy Analysis
- Insurance Terminology
Certification
- Registered Medical Assistant (RMA)
- Certified Clinical Medical Assistant (CCMA)
Languages
Fluent in English and Creole
Timeline
Denial Analyst
R1 Rcm
07.2023 - Current
Care Coordinator and Appeals Specialist
Whole Family Health Center
09.2020 - Current
Medical Assistant/Referral Coordinator
Midway Primary Care
10.2016 - 10.2020
Appeals and Collection Specialist
Advanced Healthcare for Women
11.2011 - 10.2016
Associate of Applied Arts - Medical Assisting
Adult Education of Vero Beach
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