Dominique Williams
Mckinney
Summary
Experienced & Initiative-taking Professional Leader with 10+ years of healthcare experience and expertise. Reliable multitasker with excellent organization skills, Results oriented with a proven history of collaborating with Team members to successfully achieve goals.
Overview
13
13
years of professional experience
Work History
Sr. Account Representative
Zelis Healthcare
12.2019 - Current
- Maintained the claim flow as well as Audited for over Seventy-five Third Party Administrators and other Insurance billing Companies.
- Audited as well as manually priced all medical claims submitted from TPA’s and other Claims vendors via 837 or API connections.
- Managed multiple implementation projects concurrently, maintaining strict deadlines without compromising quality or scope via 837 or API connections.
- Supported clients via Help Desk tickets with great Customer service and excellent response time.
- Conducted regular client meetings to review account performance, identify opportunities for growth, and address any concerns.
System Integration Senior Analyst
NTT Data, Inc.
03.2019 - 12.2019
- Providing software updates regarding Institutional and Professional 835 Remittance, Claims, EDI, and Electronic Funds Transfer.
- Optimized system performance by monitoring, analyzing, and tuning integration components as needed.
- Ensured seamless communication between software applications through thorough API testing and debugging.
- Maintained up-to-date documentation on all integration projects, allowing for easy reference and future enhancements.
Auditor I & Auditor II
Cotiviti
08.2014 - 03.2019
- Developed a modeling tool that extracts data from Contractual agreements to generate potential claims for commercial lines of business.
- Ensured the integrity of financial reporting by verifying the accuracy of accounting records and reconciliations.
- Created SQL queries after analyzing large data sets from paid claims from Insurance payors.
- Assisted research analyst who is responsible for developing the algorithms to ensure configuration is accurate.
- Developed strong relationships with clients, building trust and ensuring a high level of satisfaction during the audit process.
Processing Analyst
Care Options for Kids
04.2012 - 03.2019
- Maintained all Care Plans for Active patients and retro-active patients with Medicare, Medicare or private insurance.
- Examined all Re-evaluations submitted by treating Occupation, Physical and Speech therapist.
- Oversaw team of Manage-care benefits specialist and lead in quarterly goals leading to increased referrals.
- Performed verification calls to Primary care providers to assist with timely patient discharges.
- Confirmed all authorizations, authorization extension and coverage dates from Primary care providers.
Education
Bachelor of Arts -
Western Governors University
Dallas, TX01.2020
Bachelor of Arts -
Clayton State University
Jonesboro, GA01.2011
High school -
Riverdale High School
Riverdale, GA01.2007
Skills
- Project Management
- Process Improvement
- Problem Solving & Decision-Making
- Analytical thinking
- Task prioritization
- Organizational skills
- Attention to detail
- Data analytics
Timeline
Sr. Account Representative
Zelis Healthcare
12.2019 - Current
System Integration Senior Analyst
NTT Data, Inc.
03.2019 - 12.2019
Auditor I & Auditor II
Cotiviti
08.2014 - 03.2019
Processing Analyst
Care Options for Kids
04.2012 - 03.2019
Bachelor of Arts -
Western Governors University
Bachelor of Arts -
Clayton State University
High school -
Riverdale High School
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