DEIDRE NORTHINGTON
Houston,TX
Summary
Detail-oriented healthcare administrative professional with experience in back-office insurance verification, medical billing support, eligibility review, and quality assurance. Proven ability to maintain high accuracy, HIPAA compliance, and consistent productivity in non-customer-facing, documentation-focused environments. Seeking a non-call, operations-based role within healthcare administration.
Overview
7
7
years of professional experience
Work History
Healthcare Administrative / Claims Operations Specialist
Premera Blue Cross, BCBS Association
Houston, TX
02.2024 - 01.2025
- Performed back-office processing of insurance and claims documentation with high accuracy
- Verified insurance eligibility, benefits, and authorization requirements to support clean billing
- Reviewed medical records and claim data for completeness and compliance
- Maintained detailed documentation within EHR and payer systems
- Met productivity and quality benchmarks in a non-phone, operations-based role
- Supported revenue cycle teams by reducing errors and rework
Quality Assurance / Review Analyst
Maximus
Houston, Texas
09.2022 - 02.2024
- Completed audit and quality reviews of documentation and claims activity
- Identified trends and discrepancies impacting compliance and accuracy
- Maintained consistent quality scores in guideline-driven workflows
- Performed non-customer-facing review work focused on accuracy and policy adherence
Insurance Verification / Revenue Cycle Support Specialist
Humana
Houston, Texas
05.2021 - 09.2022
- Conducted insurance verification and eligibility review for commercial and government plans
- Validated demographic and payer information to prevent billing delays
- Ensured strict HIPAA compliance and confidentiality standards
- Collaborated internally with billing and claims teams (no patient phone work)
- Healthcare Organization
Medical Collection Specialist
Acclara
Houston, TX
11.2020 - 05.2021
- Focused on insurance collections for hospital and facility claims, working primarily with payers rather than patients
- Reviewed claim status, submitted appeal letters for denied claims, and followed up to ensure timely resolution
- Negotiated and collected on past-due insurance accounts, contributing to reduced outstanding balances
- Verified insurance coverage, determined patient responsibility, and resolved escalated claims issues
- Maintained detailed documentation of collection, appeal, and resolution activities in compliance with payer requirements
Collection Representative
Pra Group Inc
Burlington, NC
02.2018 - 11.2020
- Managed recovery plans for past-due hospital and facility billing accounts
- Reviewed and prepared collection and aging reports, tracking outstanding balances and payment activity
- Negotiated payment arrangements and resolved billing variances through research and account analysis
- Ensured system accuracy, compliance, and thorough documentation of all collection and resolution activities
Education
Bachelor of Science - Health Administration
University of Phoenix
Skills
- Insurance Eligibility & Benefits Verification
- Medical Billing & Revenue Cycle Support
- Authorization & Pre-Certification Review
- Claims & Documentation Processing (Non-Call)
- Quality Assurance & Audit Review
- Medical Records & Data Validation
- HIPAA Compliance & Confidentiality
- EHR & Claims Systems: Epic, NextGen, CPR, Avaya
- Data Entry Accuracy & Productivity Tracking
Websites
Additional Information
Experienced in remote work environments, Strong attention to detail and documentation accuracy, Comfortable with structured, policy-driven workflows
Work Preference
Open to Remote & Hybrid Roles
Timeline
Healthcare Administrative / Claims Operations Specialist
Premera Blue Cross, BCBS Association
02.2024 - 01.2025
Quality Assurance / Review Analyst
Maximus
09.2022 - 02.2024
Insurance Verification / Revenue Cycle Support Specialist
Humana
05.2021 - 09.2022
Medical Collection Specialist
Acclara
11.2020 - 05.2021
Collection Representative
Pra Group Inc
02.2018 - 11.2020
Bachelor of Science - Health Administration
University of Phoenix