Drenisha Nash
Midlothian,TX
Summary
Experienced and dedicated accounts receivables and accounts payable specialist seeking an opportunity to contribute expertise to a rapidly growing organization. Eager to learn and driven by a strong desire for success, confident in ability to be an invaluable asset to the company.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Refund Coordinator
Propath Laboratory
01.2024 - Current
- Responsible for researching and processing all potential overpayments, refund requests, credit balances for guarantors or payers, and appealing any recoupments that are deemed incorrectly processed by payers.
- ensuring money is correctly applied and refunded to the appropriate party in a timely manner in accordance with guarantor and payer refund policies.
- Use proper appeals/reconsideration protocol specific to each health plan as required for refund requests and recoupments that are according to contract
- Contact insurance companies as needed for appeals/reconsideration status on outstanding appeals for recoupments
- Perform proper adjustments on accounts to reflect correct balance to guarantor or payer.
- Communicate refund trends to management as identified.
Billing Analyst
KUR Research
04.2023 - 10.2023
- Collaborated with accounting team ensuring invoicing completion.
- Verified vendor invoice allocations to appropriate billers with precision.
- Oversaw routine accounts receivable procedures with meticulous attention to detail.
- Addressed and clarified vendors' complex payables concerns.
- Posted incoming receivables to CTMS and Netsuite databases.
- Reviewed and updated site invoiceables ahead of next billing period.
- Facilitate accurate processing of vendor payments using ACH/Check.
AR/Technical Denials Mngmt II
Medix (UTSW & Arbor Diagnostic)
10.2021 - 01.2023
- Evaluated denied claims to determine eligibility for reconsideration.
- Communicated with payers through online platforms, calls, and written correspondence regarding outstanding balances.
- Acted as resource person for departmental staff, aiding with issue resolution.
- Validated payments efficiently using internal and external resources for accurate reimbursement.
- Analyzed Managed Care contracts to align with reimbursement criteria.
A/R Claims Specialist
Remedy RCM
05.2018 - 08.2021
- Ensured accurate processing of refunds after reviewing recovery documents.
- Processed inbound correspondence to determine necessary actions on patient claims.
- Drafted medical appeals for claim payment resolutions.
A/R Billing Specialist / Quality Assurance
FTGU Medical Consultants
07.2013 - 09.2018
- Analyzed denied claims and developed medical appeals for payment recovery.
- Compiled monthly denial management reports for client assessment.
- Assessed inbound correspondence and executed actions on patient claims.
- Managed billing processes for electronic and manual claims.
- Examined error trends to enhance accuracy in claim processing.
- Reviewed and ensured quality of SOP's.
- Streamlined procedural steps for assessing healthcare assistance requests.
- Evaluated and facilitated the submission of refunds following receipt of carrier deduction notices.
Education
BS - Public Health
University of Texas at Arlington
AS - Health Education
Tarrant Community College
Fort Worth, TX01.2020
Skills
- Microsoft Office (Excel, Powerpoint, Word)
- ICD 9 & 10
- EDI Systems (Kareo, Centricity, Nextgen, EPIC, Advanced MD)
- Gateway
- RealMed
- Optum
- Express Scripts
- CVS Caremark
- Netsuite
- CTMS
- Communication
- Process Implementation
- Auditing
Certification
Vocational Nursing
Timeline
Refund Coordinator
Propath Laboratory
01.2024 - Current
Billing Analyst
KUR Research
04.2023 - 10.2023
AR/Technical Denials Mngmt II
Medix (UTSW & Arbor Diagnostic)
10.2021 - 01.2023
A/R Claims Specialist
Remedy RCM
05.2018 - 08.2021
A/R Billing Specialist / Quality Assurance
FTGU Medical Consultants
07.2013 - 09.2018
BS - Public Health
University of Texas at Arlington
AS - Health Education
Tarrant Community College
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