Sabrina Waters
Milwaukee
Summary
A professional billing specialist with over 5 years in outstanding service. Proficient in working with systems like Epic and Microsoft Word, with an understanding of medical terminology. Proven ability to navigate complex billing processes, and resolve inquiries effectively.
Overview
9
9
years of professional experience
Work History
Front End Billing Specialist
Prevention Genetics
Marshfield
05.2024 - Current
- Receiving, verifying, and documenting patient information, including insurance details and contact information.
- Contacting insurance payors by phone or portal to verify eligibility and coverage.
- Calculating patient cost-sharing obligations (copays, deductibles), and informing patients about their financial responsibility.
- Communicating with patients to address inquiries or concerns about the billing process.
- Requesting pre-authorization for procedures or services from insurance companies by phone, fax, or portal, with required medical documents.
Prior Authorization Specialist
Rheumatic Disease Center
Glendale
06.2022 - 02.2024
- Verifies eligibility and benefit levels to ensure patient plan covers treatment.
- Obtains clinical information to support medical necessity and submits to payor Medicare, Medicaid and commercial.
- Knowledge of ICD-10, CPT and HCPC codes.
- Educates patients of the step of submitting prior authorizations so they can be aware of time frames and covered and non covered services.
- Coordinates peer-to-peer reviews, when required.
- Completes accurate documentation in healthcare software EPIC
- Work closely with 8 providers to discuss approvals, denials and appeals
Member Service Representative
Common Ground
Brookfield
01.2019 - 05.2022
- Answered over 75 inbound calls about members' insurance plans they selected.
- Provided a high level of quality service to members and providers in the areas of enrollment, premium payment, invoicing, benefits, and claims; services via telephone, email, and other.
- Advised members how claims were processed, explained why, and if there were any patient responsibilities.
- Processed payments for members' coverage of health plans.
- Routed calls into the correct queue.
- Managed difficult situations calmly and effectively, while maintaining a positive attitude with each member or provider.
Customer Service Representative
Skygen Usa
Menomonee Falls
01.2016 - 06.2018
- Inbound call center handled up to 90 to 120 calls per day.
- Upheld privacy and security requirements established by HIPAA.
- Reviewed patient records and health history to share with dentists to ensure all treatment was billed correctly.
- Advised members of the plans in which they are enrolled.
- Answered questions about what is covered and what is not covered.
- Quickly and proficiently documented every conversation with either the patient, payor, and/or provider.
Education
GED -
DPI
Madison, WI12-2012
Skills
- Insurance verification
- Patient billing
- ICD-10 coding
- CPT coding
- Healthcare documentation
- Claims processing
- Patient communication
- Problem solving
- Time management
- Denial management
Timeline
Front End Billing Specialist
Prevention Genetics
05.2024 - Current
Prior Authorization Specialist
Rheumatic Disease Center
06.2022 - 02.2024
Member Service Representative
Common Ground
01.2019 - 05.2022
Customer Service Representative
Skygen Usa
01.2016 - 06.2018
GED -
DPI
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