Derrisha Cheatham
CA
Summary
Successful at efficiently handling client inquiries, billing and administrative tasks. Familiar with contracts and other documents affecting billing processes. Prepares professional, polished statements, and business correspondence.
Overview
8
8
years of professional experience
Work History
Credentialing Logger
Elevate (Delta Dental)
06.2024 - Current
- Evaluate provider applications before sending to a provider onboarding specialist for processing
- In the event of missing information in the provider's application, document the details and escalate to either the onboarding specialist or verification team
- They will initiate contact with the provider to acquire the necessary documents to finalize the application process.
Revenue Cycle Specialist
Kids Care Dental & Orthodontics
12.2021 - 06.2024
- Submitted claims to insurance companies for review and payment, ensuring all supporting documentation was included
- Managed and escalated inbound calls from upset parents regarding bills they received, providing resolution and support
- Verified information with insurance companies over the phone to ensure the continued processing of claims
- Responded to inquiries and issues submitted via the company website and managed tickets promptly
- Addressed claim denials by drafting and submitting detailed appeal letters
- Conducted audits using Dentrix, EagleSoft, and Edge software to validate account balances and determine payer responsibility
- Followed up with insurance companies on the status of claims, verified the amounts paid, and determined patient financial responsibility
- Investigated reasons for claim denials and decided on the need for appeal letters
- Deposited checks received from insurance companies and patients, ensuring accurate processing
- Scanned denial and approval documents and uploaded them into patient charts for proper record-keeping.
Billing Specialist
Optum 360
03.2021 - 07.2021
- Monitored outstanding balances and managed the preparation of invoices, ensuring complete reconciliation of billing and accounts receivable
- Provided input to policy systems, methods, and procedures for the effective management and control of the premium billing function
- Conducted quality assurance and audits of billing activities to ensure accuracy and compliance with company standards
- Interacted with attorneys to gather and support billing documents, ensuring invoice accuracy and resolving specific billing discrepancies.
Customer Support
Care Innovations
08.2019 - 02.2021
- Managed both inbound and outbound calls to address customer needs, including processing replacements for defective medical equipment
- Assisted patients and clinicians with troubleshooting issues related to medical equipment, ensuring timely and effective resolutions
- Helped customers with complaints and questions about products and services, providing clear and accurate information
- Processed product returns and scheduled FedEx pick-ups for the convenient return of medical equipment.
Administrative Assistant
VSP
10.2018 - 07.2019
- Edited CMS denial letters for correct spelling, grammar, and punctuation to ensure professional and accurate communication with providers and members
- Generated, processed, and managed word processing letters for both providers and members
- Handled undeliverable mail and re-issued zero and voided checks, ensuring accurate and timely distribution
- Managed mail operations, including opening, sorting, filing, and distributing incoming mail appropriately
- Conducted internal audits to ensure compliance and accuracy in document processing
- Uploaded and re-scanned files through SharePoint for organized and efficient document management.
Authorizing and Appointing
Health Net Federal Services
03.2017 - 09.2018
- Added providers to the provider roster and verified their credentials to ensure they met the standards of a quality healthcare system
- Created and processed authorizations for veterans' healthcare services once consults and referrals were received from Veterans Affairs
- Managed requests for additional services on behalf of providers, ensuring timely and appropriate care for veterans
- Followed up with veterans to confirm they received care from providers and to determine if additional care was needed
- Contacted providers to confirm the receipt of provider packets for claim processing purposes
- Scheduled appointments for veterans with preferred providers based on location, services, and insurance coverage
- Mailed out billing information and electronically sent appointment confirmation details to veterans.
Education
HS Diploma - General Studies
Elinor Lincoln High
Sacramento, CA06.2009
Skills
- Time Management: efficiently prioritize tasks and manage workload to meet deadlines consistently
- Ability to manage multiple tasks simultaneously while maintaining a high level of customer satisfaction
- Effective communication and problem-solving skills
- Knowledge of compliance standards and regulations related to billing
- Proficient in Billing and Practice Management Software
- Microsoft Office Suite, SharePoint as well as basic HTML, data entry and customer relationship management (CRM) software
- Cost Control: expertise in monitoring and managing expenses to ensure budget compliance and maximize profitability
- Attention to Detail: proven ability to meticulously review and verify information to ensure accuracy and maintain high-quality standards
- Job Site Cleanup
- Safety Compliance
- Team Collaboration
- Billing systems and software
- HIPAA Compliance
- Denial Management
- Customer Engagement
- Claims Processing
- Claim submission
- Patient account management
- Insurance Verification
- Audit Procedures
- Medical billing and collections
Timeline
Credentialing Logger
Elevate (Delta Dental)
06.2024 - Current
Revenue Cycle Specialist
Kids Care Dental & Orthodontics
12.2021 - 06.2024
Billing Specialist
Optum 360
03.2021 - 07.2021
Customer Support
Care Innovations
08.2019 - 02.2021
Administrative Assistant
VSP
10.2018 - 07.2019
Authorizing and Appointing
Health Net Federal Services
03.2017 - 09.2018
HS Diploma - General Studies
Elinor Lincoln High
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