Melissa Williams
Salt Lake City,UT
Summary
Results-driven Denial Specialist at Team Health Holdings Inc. with expertise in appeals processing and claims analysis. Proven ability to enhance documentation accuracy and improve denial management processes. Strong communicator and critical thinker, adept at collaborating with healthcare providers to resolve complex issues and ensure compliance with Medicaid guidelines.
Overview
20
20
years of professional experience
Work History
Denial Specialist
Team Health Holdings Inc.
Alcoa, TN
05.2019 - 06.2020
- Analyzed denied claims to identify trends and root causes.
- Assisted in processing appeals for denied insurance claims.
- Collaborated with healthcare providers to gather necessary documentation.
- Maintained accurate records of denied claims and appeal outcomes.
- Communicated effectively with internal teams regarding claim status updates.
- Participated in training sessions to improve knowledge of denial management processes.
Endorsement Underwriting Associate
Appalachian Underwriters
Oak Ridge, TN
11.2000 - 01.2019
- Evaluated insurance applications for risk assessment and underwriting guidelines compliance.
- Collaborated with underwriters to analyze applicants' financial information and credit histories.
- Processed policy renewals and endorsements, ensuring accuracy in documentation and adherence to deadlines.
- Reviewed claims submissions to determine eligibility based on policy terms and conditions.
- Maintained up-to-date knowledge of industry regulations and market trends impacting underwriting practices.
Education
Doyle High
Knoxville, TN06.1985
Skills
- Eligibility determination
- Appeals processing
- Medicaid guidelines
- ICD-10 proficiency
- HIPAA compliance
- Claims analysis
- Denial management
- Documentation review
- Commercial insurance
- Patient rapport
- Teamwork and collaboration
- Customer service
- Problem-solving
- Problem-solving abilities
- Excellent communication
- Critical thinking
- Claims processing
- Microsoft office
- Computer proficiency
- Documentation skills
- Data entry
- Document review
Timeline
Denial Specialist
Team Health Holdings Inc.
05.2019 - 06.2020
Endorsement Underwriting Associate
Appalachian Underwriters
11.2000 - 01.2019
Doyle High