Experienced Healthcare Revenue Cycle and Insurance Follow-Up Specialist with more than 15 years of experience in patient financial services, insurance verification, denial management, claims resolution, and reimbursement recovery. Extensive experience working with insurance carriers, healthcare providers, and patients to resolve claim issues, secure reimbursement, and ensure timely account resolution. Strong background in appeals, account research, benefits verification, prior authorizations, and healthcare billing processes. Known for attention to detail, persistence in resolving complex account issues, and delivering exceptional customer service.
Work History
Patient Account Representative II, Insurance Denials and Follow-Up
7 Years
UW Medicine Valley Medical Center | 06.2019 - 06.2026
Review and resolve insurance denials for hospital and professional claims
Research denied claims and identify corrective actions to secure reimbursement
Submit appeals with supporting documentation to insurance carriers
Follow up with insurance companies regarding claim status and payment resolution
Analyze explanation of benefits and payer responses to determine next steps
Collaborate with billing, coding, registration, and clinical teams to correct claim issues
Maintain accurate and detailed account documentation and follow-up notes
Monitor aging accounts and prioritize work to improve resolution and reimbursement outcomes
Ensure compliance with payer requirements and organizational policies
Provide support to patients, providers, and insurance representatives regarding account inquiries
Financial Counselor Representative
14 Years 8 Months
Conifer Health Solutions at Highline Medical Center | 09.2004 - 05.2019
Verified insurance eligibility, benefits, and coverage for hospital and outpatient services
Obtained prior authorizations and pre-certifications for medical procedures
Explained financial responsibility including deductibles and copayments to patients
Assisted patients with billing questions and payment arrangements
Collected patient payments and maintained accurate account records
Worked with providers and insurance carriers to support claim processing
Audited accounts to ensure billing accuracy and timely reimbursement
Maintained HIPAA compliance and protected patient confidentiality
Provided high-level customer service in a fast-paced hospital environment
Medical Billing and Charge Entry Clerk
1 Year 4 Months
Talbert Medical Group | 02.2002 - 06.2003
Entered medical charges using ICD-9 and CPT coding standards
Processed high-volume billing transactions with accuracy
Verified insurance coverage and patient account information
Researched and corrected billing discrepancies
Responded to billing inquiries from patients and insurance representatives
Maintained accurate billing records and documentation
Order Entry and Data Entry Clerk
7 Months
Craig Valve | 07.2001 - 02.2002
Processed customer orders and maintained accurate records
Performed high-volume data entry and administrative support
Assisted customers and sales representatives with order inquiries
Prepared quotations, documentation, and correspondence
Managed incoming calls and maintained organized records
Data Entry and Customer Service Representative
5 Months
Food Services of America | 10.2000 - 03.2001
Processed customer orders through phone and electronic systems
Maintained accurate account records and documentation
Assisted customers with order inquiries and issues
Supported account representatives with administrative tasks
Delivered strong customer service and problem-solving support
Front Desk Agent
1 Year 3 Months
DoubleTree Hotel | 06.1999 - 09.2000
Managed guest check-in and check-out procedures
Processed payments and balanced daily cash drawers
Maintained accurate guest records and documentation
Resolved guest concerns and provided customer support
Delivered professional service in a fast-paced hospitality environment
Education
Associate Degree
Long Beach City College | Long Beach, California
Certificate - Medical Billing and Coding
Long Beach, California
Certificate - Office Administration and Reception Services
Renton Technical College | Renton, Washington
High School Diploma
Woodrow Wilson High School | Long Beach, California
Skills
Electronic Medical Records (EMR) Systems
Medical Billing Systems
Insurance Verification Platforms
Microsoft Word
Microsoft Excel
Microsoft Outlook
Data Entry and 10-Key Operations
PROFESSIONAL HIGHLIGHTS
More than 15 years of progressive experience in healthcare revenue cycle operations
Extensive experience resolving insurance denials and securing claim reimbursement
Strong ability to investigate, analyze, and resolve complex account issues
Experienced in insurance follow-up, appeals, and claims resolution
Recognized for accuracy, professionalism, and strong customer service
Skilled in managing high-volume workloads in fast-paced healthcare environments
CORE QUALIFICATIONS
Insurance Denials and Appeals
Claims Follow-Up and Resolution
Revenue Cycle Management
Accounts Receivable Follow-Up
Insurance Verification and Benefits Review
Prior Authorizations and Pre-Certifications
Patient Financial Services
Insurance Reimbursement and Appeals
Medical Billing and Charge Entry
ICD-9, ICD-10, and CPT Coding
Account Research and Problem Resolution
Electronic Medical Records
HIPAA Compliance
Customer Service Excellence
Microsoft Office Suite
Data Entry and 10-Key Proficiency
Languages
English
Timeline
Patient Account Representative II, Insurance Denials and Follow-Up
UW Medicine Valley Medical Center
06.2019 - 06.2026Read More
Financial Counselor Representative
Conifer Health Solutions at Highline Medical Center
09.2004 - 05.2019Read More
Medical Billing and Charge Entry Clerk
Talbert Medical Group
02.2002 - 06.2003Read More
Order Entry and Data Entry Clerk
Craig Valve
07.2001 - 02.2002Read More
Data Entry and Customer Service Representative
Food Services of America
10.2000 - 03.2001Read More
Front Desk Agent
DoubleTree Hotel
06.1999 - 09.2000Read More
Woodrow Wilson High School
High School Diploma
Read More
Renton Technical College
Certificate from Office Administration and Reception Services
Member/Patient Services Representative at Medix Staffing Solution/Villagecare MaxMember/Patient Services Representative at Medix Staffing Solution/Villagecare Max