Luisa M. Travis
Spring,TX
Summary
Dynamic appeals follow-up representative with a proven track record at Memorial Hermann Health System, specializing in resolving complex medical claims and enhancing payment recovery. Expertise in claims processing and effective communication fosters collaboration with teams to ensure compliance and accuracy. Consistently drives successful outcomes in high-pressure environments.
Overview
19
19
years of professional experience
Work History
appeals f/u representative
Memorial Hermann Health System
Houston, Texas
11.2023 - Current
- Managed appeals process, documenting payer responses to ensure thorough follow-up.
- Reviewed and resolved denied, rejected, and underpaid medical claims efficiently.
- Resolved denials related to authorization eligibility and medical necessity.
- Coordinated with insurance companies to recover payments for unpaid and disputed claims.
- Collaborated with billing, coding, clinical, and authorization teams to resolve complex claim issues.
- Researched payer policies, benefits, authorizations, coding, and claim history.
Claims Processor
CVS Aetna
Houston, Texas
07.2007 - 11.2023
- Processed high volumes of claims using CVS Aetna's claims management system, ensuring timely resolution.
- Verified claim data accuracy, maintaining compliance with policies and procedures.
- Analyzed contracts and claims systems to accurately determine benefit amounts, enhancing reimbursement accuracy.
- Applied coding knowledge, including CPT-4 and HCPCS codes, for accurate reimbursement.
Education
Some College (No Degree) - Medical Technology
Lone Star College
Houston, TX08-2026
Skills
Claims processing
- Claims analysis
- Claims documentation
- Regulatory compliance
- Documentation accuracy
- Problem resolution
- Attention to detail
- Customer service
- Team collaboration
- Adaptability and flexibility
- Effective communication
Timeline
appeals f/u representative
Memorial Hermann Health System
11.2023 - Current
Claims Processor
CVS Aetna
07.2007 - 11.2023
Some College (No Degree) - Medical Technology
Lone Star College