Sharda Washington
Cordova,TN
Summary
Experienced with managing appeals and dispute resolution processes effectively. Utilizes analytical skills to assess and resolve complex cases while ensuring compliance with regulatory standards. Track record of collaborating with teams to deliver timely and accurate outcomes, adapting to changing needs and requirements.
Overview
13
13
years of professional experience
Work History
Appeal Specialist
Baptist Memorial Hospital
Memphis, TN
05.2023 - Current
- Reviews clinical information and supporting documentation for outpatient or Part B to determine appeal action.
- Prepares response to appeal based on supporting information to maximize customer satisfaction
- Maintained knowledge of insurance coverage benefit levels, eligibility systems and verification processes.
- Improved claim denial resolution by thoroughly researching and identifying root causes of denials
- Collaborated with billing department staff to ensure accurate coding and charge entry, minimizing future claim denials.
- Analyzed trends in claim denials, advising management on potential areas for process improvement.
- Enhanced overall department efficiency by developing and implementing standardized procedures for handling appeals cases.
Senior Billing and Enrollment Specialist
Cigna Corporation
11.2019 - 05.2023
- Set up, manages, reconciles, processes and balance bank/customers accounts.
- Research problems and negotiates with vendors, customers and partners to handle complex issues.
- Bills and collects outstanding issues and/or issue payments.
- Identify and develop ways to improve methods and results.
- Follow up with patients and payors on outstanding accounts.
- Keep institution financially sound by tracking expenses and maintaining detailed records.
- Generating and submit invoices based upon established accounts receivable schedules and terms.
- Identify, research and resolve billing variances to maintain system accuracy and currency.
- Handle over 50 claims per day
Accounting Specialist
Vero Business Capital
03.2014 - 07.2019
- Effectively and efficiently process over 150 invoices daily in order to fund loan.
- Analyze and audit paperwork for accuracy and fraud.
- Resolve client and paperwork issues in a timely manner.
- Communicate with brokers/clients about payment issues.
- Review financial statements and data to send.
- Improve processes and policies in support organization.
- Manage client accounts, handle collections and payments.
- Used company software to perform accurate financial analysis and audits to mitigate financial risks.
- Maintained 90% accuracy while processing 1000s worth of payments.
Shift Manager
Aldi Inc
04.2012 - 05.2014
- Managed schedules, accepted time off requests and found coverage for short shifts.
- Oversaw employee performance, corrected problems and increased efficiency to maintain productivity targets.
- Trained and mentored new employees to maximize team performance.
- Controlled store inventory and reviewed cash handling and operations reports.
- Store operations ordering inventory, opening/closing store,customer service.
Education
Bachelors of Science - Fashion Merchandising, Marketing
University of Memphis
Memphis, TNSkills
- Organizational growth
- Effective communication
- HIPAA compliance
- Problem-solving capacity
- Strong analytical skills
- Claims investigation
- Data entry
Timeline
Appeal Specialist
Baptist Memorial Hospital
05.2023 - Current
Senior Billing and Enrollment Specialist
Cigna Corporation
11.2019 - 05.2023
Accounting Specialist
Vero Business Capital
03.2014 - 07.2019
Shift Manager
Aldi Inc
04.2012 - 05.2014
Bachelors of Science - Fashion Merchandising, Marketing
University of Memphis