Danielle Davison
Suffolk,VA
Summary
. Solutions-oriented Business Analyst possessing unique combination of business analysis, quality assurance testing and applications development experience in top-tier organizations. Solid SQl query writing skills paired with familiarity of visualization tools and techniques. Successful provider of financial services with over 10 years of comprehensive experience. Solid computer skills excellent working knowledge using both Iris and Avaya systems; Microsoft Excel, WordPerfect, Microsoft Word, Microsoft PowerPoint. Ability to train, motivate, and supervise customer service employees. A team player, acknowledged as "Total Quality Customer Service Professional." Managed call flow and assisted accordingly, effectively worked with insurance such as Medicare and Medicaid. Utilize interpersonal skills to assist patients. Highly versed in medical terminology. Proficient in insurance billing. Well versed in denial of claims. Ability to perform basic/and complex math. Attention to detail. 2 years Solid Medicaid and Medicare training. HEDIS performance Management training. Underwriting verifying credit standing. Solutions-oriented Business Analyst possessing unique combination of business analysis, quality assurance testing and applications development experience.
Overview
12
12
years of professional experience
1
1
Certification
Work History
General Business Analyst/Special Projects
Sentara Health Plans
Norfolk, VA
02.2019 - Current
- Maintained a superior quality rating of 100% in file handling and claims resolution
- Analyze claims to determine extent of company’s liability, make approval or denial decisions.
- Managed diverse projects for data capture, storage and forecast analysis.
- Delivered timely support by tracking issues and communicating resolutions to end users.
- Over 10 years excel experience and entering in vital data entry for analyzing and resolution
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Identified areas where workflow could be improved within the organization's coding system.
- Reviewed and processed insurance claims to ensure accuracy of information provided by clients.
- Coordinated and planned investigations of claims to confirm compensability and coverage.
- Verified details with policyholders and requested additional information.
Patient Accounting/Cash Posting Specialist
Sentara Healthcare
Chesapeake, VA
01.2017 - 02.2019
- Arranged debt repayment or established schedules for repayment based on customer's financial situation.
- Assessed patient account records to determine appropriate collection action including contacting insurance companies for additional information or payment status updates.
- Accepted and processed customer payments and applied toward account balances.
- Answered customer questions regarding account discrepancies or problems.
- Received payments and posted amounts to customer accounts.
- Researched complex billing issues and provided resolution recommendations within specified timeframes.
- Processed refund requests and reconciled deposit and patient collections.
- Took billing calls, questions and concerns from patients and third party carriers.
Patient Accounting
Sentara Healthcare
Chesapeake, VA
01.2014 - 01.2017
- Compared statements against patient files.
- Received payments and posted amounts to customer accounts.
- Investigated billing discrepancies and implemented effective solutions to resolve concerns and prevent future problems.
- Provided customer service to patients regarding billing inquiries and account information.
- Organizing documented report with payments posted for corporate office
- Locating/Resolving missing payments
- Handling Collection agency payments and applying them to Reconcile balances
- Maintained detailed notes on all patient interactions for future reference purposes.
- Analyzed claims denials from third party payers and identified potential solutions for reimbursement.
- Understanding Medicare Rules regarding billing
- Participated in networking and learning opportunities to remain current with evidenced-based practices.
Customer Service Representative
Capital One
Chesapeake
01.2012 - 01.2014
- Work with 100 professionals covering to convert over ten million accounts due to company buyout
- Technical Support to whole company in opening new accounts and upgrading existing service
- Quickly and effectively solve customer challenges
- Maintain quality control/satisfaction records, constantly seeking new ways to improve customer service
- Some Remote Work Performed when appropriate for Company/ Providing technical support when requested.
Education
Medical Billing Specialist - Coding
Tidewater Community College
Virginia Beach, VA06-2023
Bachelor of Science - Psychology
Regent University
Virginia Beach, VA01.2021
Skills
- Workflow Analysis
- Data Analysis
- Document Workflow
- Claims History Analysis
- Claims Review
- Accounting Spreadsheets
- Critical Thinking
- Decision-Making
- Payment Posting
- Invoice Processing
- Accounts Receivable Expertise
- Audit Procedures
- Research and Due Diligence
- Coding Proficiency
- Billing Dispute Resolution
Certification
- AAPC Certified
- Medical Billing Certification
- Compliance Officer
Affiliations
- Career Development Team
Timeline
General Business Analyst/Special Projects
Sentara Health Plans
02.2019 - Current
Patient Accounting/Cash Posting Specialist
Sentara Healthcare
01.2017 - 02.2019
Patient Accounting
Sentara Healthcare
01.2014 - 01.2017
Customer Service Representative
Capital One
01.2012 - 01.2014
Medical Billing Specialist - Coding
Tidewater Community College
Bachelor of Science - Psychology
Regent University