Detail oriented, excellent customer service skills, fast learning denial management professional looking to contribute to the quality of the patients care and company success
Overview
16
16
years of professional experience
Work History
Health Business Specialist
UNT Health
03.2019 - 05.2024
Responsible for denial management of Medicaid managed care and Medicare advantage plan claims
Analyzed denial reasons, identified root causes, and implemented corrective actions to prevent future denials and significantly improve revenue cycle efficiency
Submitted appeals, corrected claims, and reconsiderations as needed
Work closely with coding, billing, and clinical staff to resolve denials promptly and efficiently.
Insurance Collector
Palo Pinto General Hospital
09.2017 - 03.2019
Responsible for denial management of traditional Medicaid and then Commercial insurance payers
Filed appeals, submitted medical records, and corrected claims as needed
Worked with the insurance companies to determine the most expedient methods of collecting payment for physician services.
SR Billing Collections Rep
JPS Health Network/Acclaim Physicians Group
04.2016 - 09.2017
Responsible for denial management of Medicare advantage plans and Traditional Medicare
Analyzed denial reasons, identified root causes, and implemented corrective actions to prevent future denials and significantly improve revenue cycle efficiency
Submitted appeals, corrected claims, and reconsiderations as needed
Work closely with coding, billing, and clinical staff to resolve denials promptly and efficiently.
Health Business Associate
UNT Health
11.2010 - 04.2016
Responsible for denial management of Medicare advantage plan and miscellaneous PPO OB/GYN claims
Analyzed denial reasons, identified root causes, and implemented corrective actions to prevent future denials and significantly improve revenue cycle efficiency
Submitted appeals, corrected claims, and reconsiderations as needed
Work closely with coding, billing, and clinical staff to resolve denials promptly and efficiently.
Account Representative
Wise County Medical and Surgical Association
09.2009 - 11.2010
Responsible for timely filing, payment, and denial management of Medicaid and commercial claims
Secured payment from self pay patients
Worked with the insurance companies to determine the most expedient methods of collecting payment for physician services.
Clinical Service Representative II
UNT Health Westside clinic
04.2008 - 09.2009
Responsible for multi-line telephone system, insurance verification and patient check in, scheduling appointments, pulling prescriptions
Medical Office Specialist Extern
UNT Health Westside clinic
02.2008 - 03.2008
Checked in patients/ insurance verification, filing charts, coding at the billing office
Graduate Student Research Assistant at UNT Health Science Center Fort Worth, TexasGraduate Student Research Assistant at UNT Health Science Center Fort Worth, Texas