Shelayna Gray
North Las Vegas,NV
Summary
To obtain a career where I will use my training and skills.
Organized Medical Biller boasts 20-year career performing difficult multitasking and claims-processing tasks. Works quickly with insurance companies to resolve problematic disputes and handle patient inquiries. Brings can-do attitude to collaborating with medical professionals, insurance providers and clients to handle invoicing within high-traffic office environment.
Diligent Payment Poster with a career spent handling multiple administrative tasks in fast-paced settings. Committed to finding solutions to issues while reconciling accounts and inputting data accurately. Proficient in many software & a quick leaner
Overview
7
7
years of professional experience
Work History
Medical Loss Review Specialist
AmeriHealth Caritas
N Las Vegas, NV
01.2024 - Current
- Review and verify implant pricing.
- Review provider appeals to determine whether it has been correctly denied.
- Submit upheld letters to provider
- Extract data for additional review.
- Review coding guidelines to determine if the provider has used appropriate methods of billing & coding
Medical Coder-Remote
NTTdata
Las Vegas
03.2021 - 12.2023
- Review denied claims from healthcare providers to confirm they meet coding guidelines
- Verify if claim should be paid or denied
Customer Service Representative-Remote
Arise
Las Vegas
05.2021 - 11.2023
- Handle incoming calls for Home Depot
- Assisted customers with online purchase
- Provided status of orders
- Processed payments
- Handled customer complaints, Processed customer returns & refunds
- Answered questions about products.
Medical Biller
Management Solutions
Las Vegas
10.2019 - 01.2021
- Verify benefits for upcoming procedure contact patients to discuss benefits; Collect from commercial insurance as well as Medicare and Medicaid (NV) on non-paid or low paid claims.; Initial claim billing electronic & paper claims; Rebill claims and submit appeals as needed; Accepted credit card payments from patients over the phone and in person; Answer patient questions about balances owed; Payment posting; Prepare & make bank deposits; Worked insurance denials; Insurance aging reports; Entered charges
Payment Poster
Branson Management Company Inc.
Las Vegas
06.2017 - 09.2019
- Post payments for multiple providers, (insurance & patient); Verify claim denials; Resubmit claims as needed; Submit appeals; Answer incoming phone calls and take or credit card payments; Check patient balances for upcoming appointments; Patient AR; Collections review; Charge entry
Education
Certificate in Medical billing and insurance coding, and a certificate in HIPPA -
UEI
03.2006
diploma -
Morningside High school
06.2000
Skills
- Effective communication skills
- Payment Processing
- Insurance Verification
- HIPAA Compliance
- Payment posting
- Batch balances and reports
- Adjustment reviews
- Accurate data entry
- Overpayment identification
- Knowledgeable in [Software]
- Proficiency in [Software]
- Bill processing
- Investigative research
- Payment management
- Credit and collections
- Billing dispute resolution
- Adjustment posting
- Statement issuing
- Statement preparation
- Accounts Receivable
- Research and due diligence
- Collections
- Dispute Resolution
- Microsoft Excel
- Claims Processing
References
References upon request
Timeline
Medical Loss Review Specialist
AmeriHealth Caritas
01.2024 - Current
Customer Service Representative-Remote
Arise
05.2021 - 11.2023
Medical Coder-Remote
NTTdata
03.2021 - 12.2023
Medical Biller
Management Solutions
10.2019 - 01.2021
Payment Poster
Branson Management Company Inc.
06.2017 - 09.2019
Certificate in Medical billing and insurance coding, and a certificate in HIPPA -
UEI
diploma -
Morningside High school