Quinia Bilbrew
Jackson
Summary
Early-career medical billing and coding professional with hands-on exposure across multiple stages of the revenue cycle, including claims review, denials support, and compliance documentation. Background includes work in regulated healthcare environments supporting payer processes, documentation standards, and audit readiness. Recently earned CPC-A certification, reinforcing a strong foundation in medical coding and revenue cycle operations.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Billing Specialist
Healthcare Medical
05.2018 - 12.2018
- Followed up on multiple DME claims weekly with Medicare, Medicaid, and commercial insurance payers to support timely reimbursement.
- Verified prior authorization approvals, eligibility, and coverage requirements prior to and after claim submission.
- Reviewed Explanation of Benefits (EOBs) and remittance advice to identify denials, payment delays, or discrepancies.
- Researched claim issues and corrected authorization or documentation errors to support resubmission.
- Prepared and submitted claim corrections and appeals, ensuring all supporting documentation met payer guidelines.
- Maintained accurate, audit-ready documentation of claim activity in billing systems while ensuring HIPAA compliance.
Customer Service Representative
Conduent (Aetna)
07.2023 - 05.2024
- Responded to high-volume member and provider inquiries regarding claims status, prior authorization, eligibility, and appeals using Avaya and internal systems.
- Assisted with grievance documentation and ensured proper routing and follow-up per healthcare guidelines.
- Maintained strict confidentiality of protected health information (PHI) in accordance with HIPAA regulations.
- Collaborated with internal departments to resolve claim-related issues efficiently and accurately.
- Delivered clear explanations of healthcare benefits and processes to members and providers.
- Remote, USA
Pharmacy Technician
Walgreens
01.2019 - 01.2020
- Filled, counted, labeled, and prepared prescription medications under pharmacist supervision.
- Reviewed prescriptions for accuracy and completeness prior to processing.
- Processed and corrected third-party insurance claims, including rejections and resubmissions.
- Entered and maintained patient and prescription information in pharmacy systems.
- Assisted with inventory management, restocking, and monitoring medication expiration dates.
- Maintained HIPAA compliance while handling protected health information (PHI).
Benefits Administration Services Associate III
Conduent (Athene)
05.2024 - Current
- Process and resolve participant inquiries related to retirement and pension benefits, ensuring accuracy and adherence to plan provisions and regulatory guidelines.
- Maintain detailed, audit-ready documentation within case management systems, demonstrating strong attention to detail and data integrity.
- Review participant records, forms, and supporting documentation for completeness and accuracy prior to processing.
- Provide clear explanations of benefit provisions, payment timelines, and required documentation to participants.
- Meet strict accuracy, productivity, and timeliness metrics in a high-volume, compliance-driven environment.
- Escalate complex cases appropriately and assist team members with procedural guidance.
- Remote, USA
Education
Medical Billing & Coding -
Antonelli College
Flowood, MSMedical Coding Prep Course -
Paula Anderson Counseling and Consulting LLC
Memphis, TNSkills
- Claims Review & Denial Reason Analysis
- Prior Authorization & Eligibility Verification
- Appeals & Grievance Support
- EOB & Remittance Advice Analysis
- Medical Billing Documentation & Compliance
- HIPAA Awareness & PHI Handling
- ICD-10-CM
- CPT
- HCPCS
- EHR/EMR Systems (User-Level)
- Case Management & Billing Systems
- Microsoft Office Suite (Word, Excel, Outlook)
- Avaya Phone System
Certification
Certified Professional Coder - Apprentice (CPC-A), American Academy of Professional Coders (AAPC)
Timeline
Benefits Administration Services Associate III
Conduent (Athene)
05.2024 - Current
Customer Service Representative
Conduent (Aetna)
07.2023 - 05.2024
Pharmacy Technician
Walgreens
01.2019 - 01.2020
Billing Specialist
Healthcare Medical
05.2018 - 12.2018
Medical Billing & Coding -
Antonelli College
Medical Coding Prep Course -
Paula Anderson Counseling and Consulting LLC