Summary
Overview
Work History
Education
Skills
Certification
Languages
Timeline
Generic

Denice Brown Beckford

Virginia Beach,VA

Summary

Qualified Medical billing & coding specialist with strong knowledge of medical terminology and healthcare regulations, great customer service skills. Researched denied claims and submitted appeals. Familiar with health billing and collections.

Overview

7
7
years of professional experience
1
1
Certification

Work History

Medical Billing specialist

GUIDHEALTH
10.2022 - Current
  • Answering patient’s inquiries related to eligibility, claims, authorizations and appeals status
  • Verify the patient’s information and enter data into the billing system to ensure the information is accurate
  • Prepare and submit the insurance claims, send statements to the providers and patients
  • Reconcile payments and adjustments to patient’s accounts
  • Collect and review referrals and pre-authorizations
  • Investigate and process appeal denied claims

Grievance and Appeals Representative

HUMANA HEALTH
08.2019 - 07.2022
  • Communicate with the patients and providers to gather necessary information to clarify the details of the grievance and appeal
  • Analyzed and reviewed the medical records, claim data and documentations to understand the basis of the grievance or appeal
  • Determined whether to uphold or overturn the initial decision on an appeal
  • Ensured all grievance and appeal processes adhere to relevant standards and timelines

Senior Bilingual Medical Benefits specialist

CONDUENT
09.2017 - 07.2019
  • Acted as the primary point of contact for employees regarding their medical, pension and 401k plans
  • Assisted the new members with medical insurance plans, coverage options during open enrollment periods
  • Reviewed and verified medical claims, investigated discrepancies and worked with the insurance carriers to resolve claims issues
  • Ensured adherence to federal and state healthcare regulations like HIPPA and Cobra

Education

Diploma - Medical Billing and Coding Specialist

NCU University -Florida Technical College
09.2022

College degree - Law

Universidad Federada de Costa Rica
03.2005

Skills

  • Microsoft Excel
  • Outlook
  • QuickBooks
  • Billing & Coding
  • HIPAA compliance
  • Claim submission
  • Insurance verification
  • Payment posting
  • CPT knowledge
  • Patient billing
  • Denial management

Certification

National Certified Insurance and Coding Specialist, National Center for Competency Testing, 11/01/22

Languages

Spanish
Native or Bilingual

Timeline

Medical Billing specialist

GUIDHEALTH
10.2022 - Current

Grievance and Appeals Representative

HUMANA HEALTH
08.2019 - 07.2022

Senior Bilingual Medical Benefits specialist

CONDUENT
09.2017 - 07.2019

College degree - Law

Universidad Federada de Costa Rica

Diploma - Medical Billing and Coding Specialist

NCU University -Florida Technical College

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Denice Brown Beckford