Doshia Davis
Phoenix,AZ
Summary
Dynamic and results-oriented professional with extensive experience in claims analysis and accounts receivable management. Skilled in medical billing expertise and fostering insurance collaborations, I excel in streamlining revenue cycle operations and enhancing customer experiences. Proven track record in improving claims processing efficiency and maintaining HIPAA compliance.
Overview
10
10
years of professional experience
Work History
Claims Specialist
MEDIX
08.2024 - Current
- Reviewing patient records to identify insurance coverage or possible treatment complications that could affect claims processing
- Organize daily matrix based on amounts to be collected and determine timely filing deadlines
- Account Management
- Maintained up-to-date knowledge of regulatory changes affecting claims processing.
- Provided exceptional customer service to maintain positive relationships with all parties.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Guided members through claims denials and clarified claims procedures.
- Facilitated communication between claimants, providers, attorneys, adjusters, employers, and other parties involved in a claim.
- Investigated complex or high-value claims to identify discrepancies and fraud indicators.
A/R Specialist
MULTIPLE PRIVATE COMPANIES
11.2023 - Current
- Identified solutions to improve revenue cycle operations efficiency and effectiveness.
- Developed work schedules according to budgets and workloads, covering priority tasks.
- Interpreted and explained work procedures and policies to brief staff.
- Participated in meetings with external auditors as needed to provide support documentation related to revenue cycle operations.
- Participated in revenue cycle processes, working to maximize profitability and increase revenue.
- Participated in subordinates' tasks to facilitate productivity or help overcome difficulties.
- Account Management
A/R Specialist
THE INTERSECT GROUP
04.2023 - 10.2023
- Consulting with payors regarding changes in regulations that may affect billing practices
- Reviewing/ reprocessing claims that have been denied by payor, and resubmitting claims with corrections
- Communicating with other teams to obtain clinical documentation needed to support claims
- Reviewing patient records to identify insurance coverage or possible treatment complications that could affect claims processing
- Organize daily matrix based on amounts to be collected and determine timely filing deadlines
- Account Management
Revenue Cycle Specialist
ROBERT HALF
06.2022 - 02.2023
- Consulting with hospital administrators regarding changes in regulations that may affect billing practices
- Reviewing claims to ensure that they are correctly coded according to industry standards
- Communicating with physician's offices to obtain clinical documentation needed to support claims
- Reviewing patient records to identify insurance coverage or possible treatment complications that could affect claims processing
Customer Experience Consultant
CARMAX
10.2021 - 07.2022
- Connect with customers online and over the phone to assist them in their car purchase journey
- I used my knowledge of the CarMax inventory to provide customer support and find vehicles that would meet their needs
- Ensured a seamless transition from online to in-store purchasing to an unrivaled customer experience
- Mentor others in mastered skillsets
Auditor
STATE OF ARIZONA
03.2020 - 10.2021
- Ensures compliance with established internal control procedures by examining records, reports operating practices, and documentation
- Verifies assets and liabilities by comparing items to documentation
- Completes audit work papers by documenting audit tests and findings
- Complies with federal, state, and local security legal requirements by studying existing and new security legislation; adhering to requirements; advising management on needed actions
Medical Verifications Specialist
STATE OF ARIZONA
03.2018 - 03.2020
- Responsible for reviewing patients' case and insurance coverage information to personalize the call contents to the patient
- Study patients' scanned requisition record and input all information relating to insurance coverage
- Ensure timely processing of benefit information and seek assistance from management when necessary
- Ensure all inpatient files are available for daily verification of insurance benefits by printing census
Sr. Accounts Receivable Specialist
CVS HEALTH
08.2017 - 02.2018
- Supported long-term care residents, responsible parties, and facilities ensuring medications were delivered on time
- Verifying and collecting information for account specific billing, insurance, and coding
- Processing claims, payments, and following up on assistance applications
- Effectively managing independent workflow, while utilizing effective prioritization and organizational skills
- Thinking critically and understanding appropriate points of escalations
Insurance Specialist
MCKESSON/REMX
10.2016 - 08.2017
- Use various systems to verify and obtain insurance benefits
- Reach out to insurance companies to obtain prior authorization information
- Research Commercial, Medicaid, and Medicare plans to locate and verify pharmacy benefits
- Ensure accuracy of all accounts by verifying information received and transmitted into the system correctly
Eligibility Specialist
STATE OF ARIZONA
02.2015 - 10.2016
- Interviewed citizens that applied for services offered by the state
- Detected fraud and abuse
- Determined eligibility for state programs and other resources
- Use multiple systems to determine eligibility
Education
Bachelor of Science - Public Health
Western Governors University
Salt Lake City, UT05-2027
MEDICAL BILLING AND CODING CERTIFICATION -
US CAREER INSTITUTE
02-2025
Some College (No Degree) - Womens Studies
The University of Arizona
Tucson, AZSkills
- Complex claims consulting
- Claims analysis
- Documentation review
- Policy interpretation
- Claims investigation
- Claims processing proficiency
- Medical billing expertise
- Insurance collaboration
- Accounts receivable management
- Healthcare finance
- Insurance verification
- Medical billing
- Claims review
- HIPAA compliance
Timeline
Claims Specialist
MEDIX
08.2024 - Current
A/R Specialist
MULTIPLE PRIVATE COMPANIES
11.2023 - Current
A/R Specialist
THE INTERSECT GROUP
04.2023 - 10.2023
Revenue Cycle Specialist
ROBERT HALF
06.2022 - 02.2023
Customer Experience Consultant
CARMAX
10.2021 - 07.2022
Auditor
STATE OF ARIZONA
03.2020 - 10.2021
Medical Verifications Specialist
STATE OF ARIZONA
03.2018 - 03.2020
Sr. Accounts Receivable Specialist
CVS HEALTH
08.2017 - 02.2018
Insurance Specialist
MCKESSON/REMX
10.2016 - 08.2017
Eligibility Specialist
STATE OF ARIZONA
02.2015 - 10.2016
Bachelor of Science - Public Health
Western Governors University
MEDICAL BILLING AND CODING CERTIFICATION -
US CAREER INSTITUTE
Some College (No Degree) - Womens Studies
The University of Arizona
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