Mya Theus
Atlanta,GA
Summary
Highly motivated and detail-oriented insurance/denial followup specialist with over 5 years of experience in the healthcare industry, Seeking a position where i can utilize my skills and knowledge to ensure accurate and timely resolution of insurance claims and denials
Experience with handling billing and clerical tasks to ensure accurate and timely patient billing, troubleshooting, tech support, and customer care. Knowledgeable with major coding software,
Overview
2027
2027
years of professional experience
Work History
Billing Follow-up Specialist
TRC Staffing
Remote
2025 - Current
- Investigate claim denials, rejections, and payment discrepancies by reviewing EOBs, ERAs, payer policies, and patient accounts.
- Contact insurance companies via phone or payer portals to obtain claim status and resolve reimbursement issues.
- Verify patient insurance eligibility, benefits, authorizations, and coordination of benefits (COB) when necessary.
- Work accounts receivable (A/R) aging reports and prioritize high-value or timely filing accounts.
Insurance Denial Specialist
RSI
Remote
12.2024 - 06.2025
- Resolved denied and unpaid insurance claims for various payers
- Reviewed EOBs and payer guidelines to develop effective appeals
- Collaborated with supervisors and providers on resubmissions
- Managed high-volume queues, consistently meeting performance goals
Medicare Engagement Specialist
CVS
01.2022 - 05.2024
- Assist with Medicare and Medicaid members in regards to their medication and health care assessments
- Maintains strict patient and physician confidentiality through HIPPA
- Provides a range of clinical services in conjunction with Outpatient/Inpatient services
- Complete accurate clinical records including intakes, assessments, treatment plans and updates, progress notes and discharge information in a timely manner.
Insurance Follow-Up/Denial Specialist
Health Care Outsourcing Network
05.2019 - 01.2023
- Strong knowledge of insurance policies and procedures
- Knowledgeable of ICD-10 Coding
- Proficient in using insurance billing software and electronic health records (EHR) system
- Identified and corrected inconsistencies, deficiencies, and discrepancies in medical documentation
- Followed up on submitted claims and tracked unpaid claims; ensuring claims are submitted correctly.
- Investigate and resolve claim denials by contacting insurance companies and providing necessary documentation
Education
Bachelor of Science - Dental Hygiene
GEORGIA STATE UNIVERSITY
Atlanta, GA05.2026
HIGH SCHOOL DIPLOMA -
LANGSTON HUGHES HIGH SCHOOL
Atlanta, GA05.2017
Skills
- Microsoft Office/ Teams
- 65WPM Typist
- Communication Skills
- Analyze claim denials
- Knowledge of EPIC/EMR Software
- Proficient with payor portals
- Knowledge Of HIPPA
- Knowledgeable of EOB
- Knowledge of ICD-10 Coding
Timeline
Insurance Denial Specialist
RSI
12.2024 - 06.2025
Medicare Engagement Specialist
CVS
01.2022 - 05.2024
Insurance Follow-Up/Denial Specialist
Health Care Outsourcing Network
05.2019 - 01.2023
HIGH SCHOOL DIPLOMA -
LANGSTON HUGHES HIGH SCHOOL
Bachelor of Science - Dental Hygiene
GEORGIA STATE UNIVERSITY
Billing Follow-up Specialist
TRC Staffing
2025 - Current