Crystal Dorsey
O’Fallon,MO
Summary
Professional with strong expertise in medical billing, bringing reliable and adaptable approach to navigating evolving needs. Proven track record in team collaboration and achieving results through effective communication and problem-solving. Skilled in coding, claims processing, and patient account management, with keen eye for accuracy and compliance. Known for dependability and focus on efficiency, ready to contribute to streamlined billing operations.
Overview
11
11
years of professional experience
Work History
Medical Biller
Atlas Healthcare Partners
11.2021 - Current
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Filed and updated patient information and medical records.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
- Collected payments and applied to patient accounts.
- Posted payments and collections on regular basis.
- Reduced claim denials by meticulously reviewing patient insurance information and coding practices.
- Implemented quality control measures to identify potential errors before submitting claims, reducing rejections significantly.
SR Patient Account Representative
Conifer Health Solutions
10.2016 - 11.2021
- Maintained strict confidentiality while handling sensitive patient information in accordance with HIPAA regulations.
- Formulated strategic plans aimed at increasing patient retention rates by offering various payment plan options tailored to individual financial needs.
- Increased accuracy of billing statements through meticulous attention to detail and thorough verification of patient information.
- Reconciled account discrepancies to maintain accurate records of payments received from both patients and insurance companies.
Billing Specialist/ Appeal Writer
HealthCare Scouts
05.2016 - 10.2016
- Coordinate third party billing to various agencies and insurance companies
- Review and process daily claims ensuring accurate and correct
- Directs workflow and workload assignments for the team
- Informs claimants of documentation required to process their claim, the required time frames, payment information and claim status either by phone, written correspondence and/or claims system
- Enters verbal and written application information that meets both the internal and external customers' requirements
- Knowledge and understanding of state policy or Medicaid eligibility and low-income state resources
Claims Representative II Technical analyst
TriZetto Corporation
05.2014 - 11.2015
- Verified patient eligibility, benefits, claim status, and authorization of services
- Resolved client concerns and processed & explained benefits to clients
- Improved customer satisfaction by providing timely and accurate information on claim status and resolution.
- Maintained compliance with industry regulations by adhering to established procedures and guidelines in claims handling.
Education
BSN - Nursing
Maryville University
11-2027
Diploma - Medical Assistant
St Louis College of Health Careers
08.2017
Skills
- Account Follow up
- Denial Management
- Patient Billing
- Compliance
- Scheduling & Insurance Verification
- Eclinical Works
Certificationsandlicensures
- RMA Certification
- CPR Certified
- First Aid Certified
- Certified Nurse Assistant
Timeline
Medical Biller
Atlas Healthcare Partners
11.2021 - Current
SR Patient Account Representative
Conifer Health Solutions
10.2016 - 11.2021
Billing Specialist/ Appeal Writer
HealthCare Scouts
05.2016 - 10.2016
Claims Representative II Technical analyst
TriZetto Corporation
05.2014 - 11.2015
Diploma - Medical Assistant
St Louis College of Health Careers
BSN - Nursing
Maryville University
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