Workers’ Compensation Authorization specialist
Erica Edwards
Metro Physical & Aquatic Therapy
West Hempstead,NY
13
Years of experience
Medical billing professional managing charge entry, claim review, and aged account follow-up with a focus on clean submission and reimbursement accuracy. Handles patient records, verifies eligibility, and corrects coding discrepancies to keep billing files current. Brings the senior-level billing judgement needed to support tighter cash flow and fewer claim delays. Experienced in Workers' Compensation authorization.
Work History
Workers’ Compensation Authorization specialist
5 Years 3 Months- Verified 15 benefits requests daily to confirm authorization details before billing begins.
- Maintained accurate billing and invoicing records across patient accounts, supporting clean payment processing and follow-up.
- Coordinated with insurance providers to resolve denials, clarify coverage questions, and move claims toward approval.
- Verified ICD-9 and ICD-10 codes against supporting records to improve coding accuracy and reimbursement readiness.
- Applied HIPAA privacy compliance standards when handling patient information and sensitive authorization documents.
- Managed time-sensitive tasks independently while adapting quickly to changing billing priorities and customer needs.
- Improved team morale and productivity through effective communication and active listening skills.
- Demonstrated adaptability with changing insurance requirements, maintaining up-to-date knowledge through continuous education efforts.
- Consistently met deadlines under pressure while maintaining high-quality work output in a fast-paced environment.
- Answered and managed incoming and outgoing calls while recording accurate messages for distribution to office staff.
- Reviewed clinical documentation for completeness, accuracy, and compliance with payer guidelines.
- Edited and proofread documents for accuracy and completeness
- Expedited claim processing by submitting complete and accurate information in accordance with payer requirements.
- Promoted positive customer experiences by addressing concerns or questions related to authorizations in a professional manner.
Medical Biller
7 Years 9 Months- Handled 30 + billing inquiries weekly with insurers to support claim follow-up and dispute resolution.
- Reviewed 25 claims weekly for coding accuracy and billing completeness before submission.
- Delivered timely charge submissions in EPIC while maintaining accurate invoice documentation and system entry.
- Reviewed ICD-9 and ICD-10 coding on claims, researching discrepancies to support compliance and reimbursement accuracy.
- Maintained current accounts through aged revenue reporting and regular follow-up on outstanding balances.
- Trained new employees on billing programs and data entry procedures to support consistent team onboardin
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Resolved discrepancies in accounts receivable reports, contributing to improved cash flow management.
- Improved patient satisfaction by providing clear explanations of billing procedures and addressing billing inquiries promptly.
- Reduced instances of denied claims, carefully reviewing and rectifying coding errors before submission.
- Maintained up-to-date knowledge of billing software and healthcare regulations, contributing to department's compliance and efficiency.
- Used data entry skills to accurately document and input statements achieved significant reduction in outstanding accounts receivables by implementing rigorous follow-up procedures with insurers and patients.
- Optimized reimbursement process with insurance companies by establishing effective communication channels.
- Organized filing system for patient records, expediting access to essential documents when needed.
Education
Some college
High School Diploma
Skills
Billing and invoicing
Account posting
Invoice documentation management
Charges and rates
Aged receivables tracking
Claim scrubbing
Insurance verification
Secondary billing
Billing data verification
Billing document creation
Spreadsheet tracking
Inquiry handling
Microsoft Office
Denial management
Appeals preparation
UB-04 claim preparation
EOB interpretation
HIPAA privacy compliance
Prior authorization
Timeline
Workers’ Compensation Authorization specialist
Metro Physical & Aquatic Therapy
08.2021 - 11.2026Read More
Medical Biller
Betz Mitchell Associates
10.2013 - 07.2021Read More
Nassau Community College
Some college
Read More
West Hempstead High School
High School Diploma
Read More