QUIYANNA CONLEY
HOUSTON,TX
Summary
Dynamic professional with extensive experience in revenue cycle management at Altus Biologic's. Proven track record in claims analysis and client account management, enhancing reimbursement processes and optimizing team performance. Adept at problem-solving and fostering client engagement, ensuring compliance and efficiency in all operations.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Account Specialist
CCRM
Remote
05.2024 - Current
- Managed client accounts and maintained detailed interaction records to support relationship management.
- Resolved client inquiries and delivered timely support services to enhance client satisfaction.
- Coordinated client and internal team communication to ensure timely project updates.
- Managed patient health records using electronic health record systems.
DENIAL SPECIALIST
ARGOS HEALTH
03.2022 - 04.2024
- Sent appeal notices for incorrectly denied claims, ensuring compliance with regulatory standards.
- Analyzed denial reasons and identified patterns to support team in addressing recurring issues.
- Reviewed claims for ERISA processes to facilitate reconsiderations and appeals.
- Collected data to meet company standards for all monthly goals.
REVENUE CYCLE MANAGER
ALTUS BIOLOGICS
05.2018 - 03.2022
- Oversaw credit and collections department operations, ensuring compliance with regulatory standards and streamlined processes.
- Identified denial patterns and implemented effective solutions and strategies.
- Supported team in optimizing production and collection methods, leading to improved claim resolution outcomes.
- Assessed team training needs and facilitated monthly denial resolution processes to enhance team skillsets and effectiveness.
- Delegated tasks across the department to ensure thorough claim processing.
REVENUE CYCLE LEAD
BAY AREA REGIONAL MEDICAL CENTER
07.2016 - 05.2018
- Secured accurate payments from insurance companies, ensuring optimal revenue for patient revenue cycle department.
- Negotiated fair settlement offers for treatment expenses, facilitating financial relief for patients and the organization.
- Analyzed underpaid claims to identify trends and improve reimbursement processes.
- Verified insurance coverage and authorizations for dates of services rendered.
- Provided detailed information to patients regarding service payments and options.
Legal Research Assistant
HCA/PARALLON
11.2014 - 06.2016
- Reviewed case files to identify potential legal actions and relevant issues.
- Investigated claims and requested additional medical records, contributing to comprehensive legal analysis.
- Facilitated preparation of court documents in collaboration with legal department, ensuring compliance with legal standards.
- Coordinated trial dates for medical claims, optimizing scheduling to enhance attorney efficiency.
Education
ASSOCIATES - SOCIAL AND BEHAVORIAL SCIENCE
SAN JACINTO COLLEGE
Houston, TX01.2020
ASSOCIATES OF APPLIED SCIENCE - PARALEGAL
SAN JACINTO COLLEGE
Houston, TX01.2018
Skills
- Revenue cycle management
- Claims analysis
- Claim processing
- Denial analysis
- Contract management
- Electronic health records
- EHR management
- Medical coding
- Data collection
- Account reconciliation
- Healthcare regulations
- Problem solving
- Issue investigations
- Customer engagement
- Team development
- Strong work ethic
Certification
CERTIFIED NOTARY, TEXAS
Timeline
Account Specialist
CCRM
05.2024 - Current
DENIAL SPECIALIST
ARGOS HEALTH
03.2022 - 04.2024
REVENUE CYCLE MANAGER
ALTUS BIOLOGICS
05.2018 - 03.2022
REVENUE CYCLE LEAD
BAY AREA REGIONAL MEDICAL CENTER
07.2016 - 05.2018
Legal Research Assistant
HCA/PARALLON
11.2014 - 06.2016
ASSOCIATES - SOCIAL AND BEHAVORIAL SCIENCE
SAN JACINTO COLLEGE
ASSOCIATES OF APPLIED SCIENCE - PARALEGAL
SAN JACINTO COLLEGE