Da'Neisha Robinson
Sarasota,FL
Summary
Medical billing professional with substantial experience in healthcare revenue cycle management , claims processing, payment posting, charge entry, and scheduling. Skilled in coding, compliance, and payer relations. Known for strong collaborative approach, adaptability, and delivering results. Adept in problem-solving and maintaining accuracy in complex billing systems. Strong expertise in Medicaid and Medicare claims processing and reimbursement. Proven ability to navigate complex billing systems, ensuring accuracy and compliance with regulations. Known for effective team collaboration, adaptability, and achieving results in dynamic healthcare environments. Skilled in claims resolution, coding, and patient communication.
Overview
8
8
years of professional experience
Work History
Virtual Patient Access Representative- ER
Wellstar Heath System
Atlanta, GA
08.2023 - Current
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
- Resolved patient financial problems with guidance from documented guidelines and procedures.
- Enhanced communication between medical staff and patients, providing clear explanations of procedures and policies.
- Expedited emergency room 50+ admissions through rapid yet thorough collection of critical information.
- Served as a liaison between patients, physicians, and insurance companies to resolve any issues or concerns promptly.
- Utilized advanced computer software systems to effectively manage patient registration, documentation, and reporting tasks.
- Ensured compliance with hospital protocols by staying current on industry regulations and attending regular training sessions.
Senior Account Specialist
Northside Gwinnett Physicians OBGYN
Lawrenceville, GA
11.2023 - 07.2025
- Identified opportunities for cost savings by analyzing medical billing patterns across various departments.
- Collaborated with interdisciplinary teams to ensure smooth processing and accurate reimbursement of medical claims.
- Educated staff members on proper coding techniques through comprehensive training seminars.
- Enhanced team productivity by 92% by providing training sessions on claim processing software and regulatory updates.
- Optimized workflow processes by identifying bottlenecks within the system, implementing necessary changes for increased efficiency.
- Utilized advanced knowledge of ICD-10 codes to accurately process complex medical claims.
- Managed high volume of claims, consistently meeting deadlines without compromising accuracy or quality.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Trained newly hired administrative staff members on office policies, procedures, and best practices, fostering a supportive team environment.
- Strengthened patient relationships with consistent follow-up on test results, appointments, and referrals.
Sr. Patient Account Specialist/ Payment Poster
Emory Healthcare
Tucker
11.2021 - 08.2023
- Accurately maintain daily performance goal of 100-plus posted payments and adjustments both
- Worked with outside entities to resolve issues with billing, claims and payments.
- Posted payments and processed refunds.
- Liaised between patients, insurance companies, and billing office.
- Electronically submitted bills according to compliance guidelines.
- Prepared reports detailing billing actions, flags and other key information.
- Monitored flags and resolved urgent items with accuracy and efficiency.
- Entered client details and notes into billing systems (Epic, Gammis, etc.) for interdepartmental access and review.
- Researched billing errors and discrepancies to initiate corrective action.
- Analyzed customer financial records to determine appropriate payment plan.
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Delivered timely and accurate charge submissions.
- Generated reports and analyzed trends to maximize reimbursement and reduce claim denials.
- Audited and corrected billing and posting documents for accuracy.
- Generated accounts payable reports for management review to aid in financial and business decision making.
- Offered ample support to team members with creative solutions to complex challenges regarding scheduling, conflict resolution, and medical care.
- Contributed to and helped lead employee staff meetings, reporting trends in procedures, advising leadership on resources needed and preparing information to be disseminated.
- Provided exceptional customer service to patients, answering questions and addressing concerns.
- Filed and maintained patient records in accordance with HIPAA regulations.
- Achieved high satisfaction rating through proactive one-call resolutions of customer issues.
- Compiled status and performance reports for team leaders to address company strengths and weaknesses.
- Managed large volumes of data efficiently and with great care on daily basis.
Sr. Patient Access Specialist
Children's Healthcare Of Atlanta
Atlanta, GA
07.2021 - 11.2021
- Coordinated patient scheduling, check-in, check-out and payments for billing.
- Checked patient insurance, demographic, and health history to keep information current.
- Helped patients complete necessary medical forms and documentation.
- Maintained strict confidentiality of patient information, adhering to HIPAA regulations and medical office policies.
- Managed high call volumes, directing calls to appropriate departments while maintaining a polite and professional demeanor.
- Provided compassionate customer service, creating a welcoming atmosphere for patients and their families.
- Enhanced patient satisfaction 95% by efficiently managing the front desk operations and addressing inquiries in a timely manner.
Sr. Patient Financial Service Specialist/Claims Specialist
Kaiser Permanente
Duluth
05.2017 - 02.2021
- Answered 80 - 100 inbound calls daily from existing and future policyholders to answer inquiries and discuss insurance options.
- Gathered information, assessed and fulfilled callers' needs and educated on important policies and procedures.
- Identified, analyzed and researched systemic issues and made recommendations for resolution.
- Maintained confidential patient, employee and company information in compliance with company policies and regulatory requirements.
- Filed and maintained patient records in accordance with HIPAA regulations.
- Verified insurance eligibility and coverage for patients.
- Handled customer service inquiries in person, via telephone and through email.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Entered patient demographic and insurance data into electronic medical record system.
- Built and maintained positive working relationships with patients and staff.
- Managed patient registration process, confirming data accuracy and completeness.
- Took copayments and compiled daily financial records.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Verified patient insurance coverage and benefits for medical claims.
- Managed large volume of medical claims on daily basis.
- Researched and resolved complex medical claims issues to support timely processing.
- Paid or denied medical claims based upon established claims processing criteria.
- Monitored and updated claims status in claims processing system.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Identified and resolved discrepancies between patient information and claims data.
- Followed up on denied claims to verify timely patient payment and resolution.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Generated reports on medical claims processing activities and results.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Examined claims forms and other records to determine insurance coverage.
- Maintained claims data in multiple billing systems.
- Managed and motivated employees to be productive and engaged in work.
- Accomplished multiple tasks within established timeframes.
- Maintained professional, organized, and safe environment for employees and patrons.
- Resolved staff member conflicts, actively listening to concerns and finding appropriate middle ground.
- Cross-trained existing employees to maximize team agility and performance.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Achieved insurance pre-authorizations to enable timely patient procedures.
- Updated patient records with accurate, current insurance policy information.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
- Established and maintained relationships with insurance providers for productive communications.
- Posted payments to accounts and maintained records.
- Generated reports to track insurance verifications and claim progress.
- Trained new staff on current, correct insurance verification procedures.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
- Registered and verified patient records before triage with most up-to-date information.
Education
Associate of Science - Biochemistry
Georgia State University
Atlanta, GA12.2024
Skills
- Payment Processing
- Verbal and Written Communication
- Proficiency of EMR Systems
- Excellent Knowledge of Medicare, Medicaid, Commerical Insurance, etc
- Provider Relations
- Claims Investigation and Research
- Medical Billing
- Insurance Eligibility Verifications
- Denial Appeals Process
- Collections and Invoice Processing
- Pre-Authorizations
- Leadership
- EMR systems proficiency
- EMR Software
- HIPAA compliance
Timeline
Senior Account Specialist
Northside Gwinnett Physicians OBGYN
11.2023 - 07.2025
Virtual Patient Access Representative- ER
Wellstar Heath System
08.2023 - Current
Sr. Patient Account Specialist/ Payment Poster
Emory Healthcare
11.2021 - 08.2023
Sr. Patient Access Specialist
Children's Healthcare Of Atlanta
07.2021 - 11.2021
Sr. Patient Financial Service Specialist/Claims Specialist
Kaiser Permanente
05.2017 - 02.2021
Associate of Science - Biochemistry
Georgia State University