Kacee Jones
Walters
Summary
Seasoned Denial Specialist with solid experience in medical billing and insurance claims. Strong understanding of denial management processes, claim reviews, and appeals procedures. Demonstrated ability to work well under pressure while maintaining high attention to detail and accuracy. Proven record of improving efficiency within healthcare financial operations.
Overview
5
5
years of professional experience
Work History
Denials Specialist
United Regional Health Care System
Wichita Falls
03.2023 - Current
- Resolved complex denials on hospital claims for commercial payers, ensuring accurate reimbursement in alignment with contractual obligations.
- Maintained up-to-date knowledge of payer-specific guidelines and policies to support timely and compliant claim submissions.
- Ensured timely and correct processing of claims to maximize revenue and minimize rejections or delays.
- Collaborated with management to troubleshoot escalated issues and develop strategic solutions for denial trends and recurring claim problems.
Professional Biller
United Regional Health Care System
Wichita Falls
02.2022 - 03.2023
- Managed all governmental insurance denials related to professional billing, ensuring compliance with payer guidelines and maximizing reimbursement.
- Reviewed payments to verify alignment with payer contracts and reimbursement schedules; initiated adjustments, appeals, or refunds as necessary.
- Investigated overpayments and underpayments, performing account reconciliation and processing appropriate credits or corrections.
- Ensured accurate reprocessing of claims and prepared appeals for denied claims with appropriate supporting documentation.
- Monitored and maintained credit balances, applying payments appropriately and resolving discrepancies to ensure clean account resolution.
- Submitted clean, accurate claims to reduce future denials and improve first-pass resolution rates.
- Communicated effectively with payers, patients, and internal departments to expedite claim resolution and identify process improvements.
Billing Clerk
United Regional Health Care System
Wichita Falls
12.2021 - 02.2022
- Responsible for the following:
- Review and sort correspondence; attach appropriate documentation for mailing to patients.
- Prepare and process paper billing claims for both Professional Billing (PB) and Hospital Billing (HB) cycles.
- Respond promptly to departmental emails, especially regarding tracer information and mailing needs.
- Maintain an adequate inventory of office supplies and place orders when necessary.
- Ensure all copy machines are stocked with paper and ready for use.
- Coordinate with team members to ensure timely and accurate mailing of all documents.
- Uphold confidentiality and accuracy when handling patient information and billing data.
Entry Screener
United Regional Health Care System
Wichita Falls
04.2021 - 12.2021
- Screened all patients for COVID-19 symptoms prior to building entry to ensure safety and compliance with health protocols.
- Managed patient check-in process efficiently, verifying appointment details and facilitating timely access to care.
- Coordinated patient flow to minimize wait times and support smooth clinic operations during high-demand periods.
Rehab Clerk
Faith Community Hospital
Jacksboro
10.2020 - 04.2021
- Scheduled patient appointments for physical and occupational therapy, optimizing provider availability and patient care continuity.
- Obtained and verified insurance authorizations prior to therapy initiation to ensure coverage and prevent billing delays.
- Accurately gathered and entered patient information into the hospital’s electronic medical record (EMR) system, maintaining data integrity.
- Maintained up-to-date patient charts and documentation to support clinical and administrative needs.
- Generated and distributed departmental reports to assist management in tracking operational performance and resource allocation.
Education
Bachelor’s - Health Care Administration
Abilene Christian University Online
Abilene, TX12.2024
High School Diploma -
Liberty University Online
Lynchburg, VA10.2019
Skills
- Documentation review
- Claims analysis
- Appeals processing
- Commercial insurance
- Problem-solving
- Team collaboration
- Continuous improvement
Timeline
Denials Specialist
United Regional Health Care System
03.2023 - Current
Professional Biller
United Regional Health Care System
02.2022 - 03.2023
Billing Clerk
United Regional Health Care System
12.2021 - 02.2022
Entry Screener
United Regional Health Care System
04.2021 - 12.2021
Rehab Clerk
Faith Community Hospital
10.2020 - 04.2021
Bachelor’s - Health Care Administration
Abilene Christian University Online
High School Diploma -
Liberty University Online