SHERRY HOUSTON
Farmington,AR
Summary
Experienced Insurance Claims Analyst with over 12 years in healthcare revenue cycle management, specializing in denial resolution and medical billing. Skilled in resolving complex claims and optimizing reimbursement through effective appeals. Led training initiatives to enhance operational efficiency and ensure compliance with regulatory requirements. Knowledgeable in Epic and EMR systems, with expertise in Commercial insurance, Medicare, Medicaid, and HIPAA compliance.
Overview
3
3
years of post-secondary education
18
18
years of professional experience
Work History
Senior Insurance Claims Analyst
Washington Regional Medical Center
Fayetteville, AR
12.2018 - Current
- Review and appeal denied claims to maximize reimbursement.
- Resolved complex insurance billing issues through thorough claim research and effective payer communication, enhancing claim accuracy.
- Assisted team members in resolving complex claims.
- Train and mentor new Insurance Claims Analysts on billing procedures, systems, and compliance requirements.
- Maintained up-to-date knowledge of payer policies and reimbursement guidelines to ensure compliance and optimal claims processing.
- Successfully perform all responsibilities in a fully remote environment since 2022.
- Participated in special projects as assigned by management, such as developing new methods for evaluating risk factors associated with certain types of claims.
Billing Specialist
Ozark Guidance Center
Springdale, AR
10.2013 - 11.2018
- Prevented revenue loss through accurate authorization management and timely billing practices.
- Verified Medicaid payments and investigated unpaid or underpaid claims to expedite resolution.
- Coordinated billing documentation with clinical staff, enhancing accuracy and maintaining compliance standards.
- Managed authorizations for 2,000 Medicaid clients, ensuring timely processing and compliance.
- Maintained electronic tracking systems and revised fee agreements.
Release of Information Specialist
HealthPort at Northwest Medical
Springdale, AR
01.2012 - 10.2013
- Processed medical record requests for patients, attorneys, insurance companies, and government agencies, ensuring timely and accurate delivery.
- Processed medical record requests for patients, attorneys, insurance companies, and government agencies.
- Prepared medical records for Medicare, Medicaid, and insurance audits, facilitating compliance with regulatory requirements.
- Maintained production tracking and accurate electronic documentation, supporting efficient record management and retrieval.
Medical Records Coordinator
Piney Ridge Center
Fayetteville, AZ
12.2008 - 02.2012
- Promoted twice, initially hired as the receptionist then was quickly promoted to the Medical Records Clerk and finally the Medical Records Coordinator at the end of 2009.
- Managed the Medical Records Department for an 86-bed residential psychiatric facility.
- Coordinated documentation requests for physicians, clinicians, and nursing staff to facilitate timely access to patient information.
- Maintained electronic medical records and prepared departmental reports to support accurate patient care and data management.
- Supervised departmental staff and coordinated chart audits to ensure compliance with regulatory standards.
- Conducted HIPAA training for new employees.
Education
High School Diploma -
Fayetteville High School
Fayetteville, AR 08.1996 - 05.1999
Skills
- Epic Hyperspace
- Revenue Cycle Management
- Insurance Appeals
- Denial Management
- Prior Authorizations
- Microsoft Office
- EMR/EHR Systems
- HIPAA Compliance
- Remote Team Collaboration
- Facility Medical Billing
- Professional Medical Billing
- General Medical Coding Knowledge
Timeline
Senior Insurance Claims Analyst
Washington Regional Medical Center
12.2018 - Current
Billing Specialist
Ozark Guidance Center
10.2013 - 11.2018
Release of Information Specialist
HealthPort at Northwest Medical
01.2012 - 10.2013
Medical Records Coordinator
Piney Ridge Center
12.2008 - 02.2012
High School Diploma -
Fayetteville High School
08.1996 - 05.1999