Staci Davis
Phoenix,AZ
Summary
Medicare sales professional with comprehensive understanding of customer engagement and policy navigation. Recognized for developing effective sales strategies and building strong client relationships. Emphasizes collaboration within teams to achieve optimal results, consistently adaptable to changing market conditions.
Overview
13
13
years of professional experience
Work History
Medicare Sales Agent
UHC - United Health Care Group
08.2022 - Current
- Answer incoming phone calls from prospective members, identify the type of assistance and information the customer needs with the goal to convert the caller to a qualified lead and sale
- Follow up with members on questions or to review current or new products and services
- Navigate multiple computer systems to document member information while maintaining active listening and engagement with members
- Demonstrate knowledge of the product portfolio by addressing needs of members, explaining the differences between products, and assisting selection of products to best meet their needs
- Assist in completion of the enrollment application over the phone, staying consistent with product requirements and enrollment guidelines
- Meet the goals established for the position in the areas of performance, attendance, and consumer experience
- Meet and maintain requirements for agent license, appointments, and annual product certification
- Licensed in 50 states
Insurance Phone Rep/Collector
Orthoarizona Foot And Ankle Institute
10.2020 - 08.2022
- Answer Inbound Patient calls, pertaining to billing and Insurance questions
- Assist patients with payments
- Set up payment plans
- Filed and submitted insurance claims
- Investigated denials and collaborated with internal team members and third-party representatives to identify solutions
- Effectively coordinated all communications between patients, billing personnel and insurance carriers
- Flagged return claims and dealt with insufficient payments
- Managed billing, waivers, and claims for private and commercial clients
- Researched and communicated insurance requirements, including patient financial responsibilities and fee-for-service
- Maintained accurate and timely charge submissions utilizing electronic charge capture practices, including billing and account receivables (BAR) system and medical billing clearinghouse accounts
Medical Biller/Collector
Harmony Medical Care
01.2020 - 05.2020
- Submit claims to Insurance
- Contact Patients about Insurance or billing
- Contact Insurance about denials, rejections, and payments
- Submit Patient Medical Records
- Submit Appeals and Grievance to Insurance on denied/rejected claims
Reimbursement Specialist III
Dexcom Inc
06.2017 - 07.2019
- Evaluated patients' financial status and established appropriate payment plans
- Accurately posted and sent out all medical claims
- Posted and adjusted payments from insurance companies
- Maintained and updated collections tracking spreadsheet to help organize payment information
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls to ensure proper payments according to contracts
- Located errors and promptly refiled rejected claims
- Communicated effectively and extensively with other departments to resolve claims issues
- Printed and reviewed monthly patient aging reports and solicited overdue payments
- Researched CPT and ICD-10 coding discrepancies for compliance
Insurance Verification Specialist
Simon Med Imaging
05.2016 - 06.2017
- Observed strict procedures to protect sensitive patient information, including medical records and payment data
- Verified client information by analyzing existing evidence on file
- Contact with insurance carriers to discuss policies and individual patient benefits
- Maintained strong knowledge of basic medical terminology to better understand services and procedures
- Assured timely verification of insurance benefits prior to patient procedures or appointments
- Determined appropriateness of payers to protect organization and minimize risk
- Coached new employees on administrative procedures, company policies and performance standards
Insurance Verification Specialist
A/R Ironwood Cancer Research
05.2015 - 04.2016
- Maintained strong knowledge of basic medical terminology to better understand services and procedures
- Assured timely verification of insurance benefits prior to patient procedures or appointments
- Determined appropriateness of payers to protect organization and minimize risk
- Coached new employees on administrative procedures, company policies and performance standards
- Posted and adjusted payments from insurance companies
- Maintained and updated collections tracking spreadsheet to help organize payment information
Medical Billing Specialist
Momdoc Women for Women
02.2014 - 04.2015
- Posted and adjusted payments from insurance companies
- Evaluated patients' financial status and established appropriate payment plans
- Precisely completed appropriate claims paperwork, documentation, and system entry
- Oriented and trained inexperienced staff on proper procedures and policies
- Printed and reviewed monthly patient aging reports and solicited overdue payments
- Managed collections claim for unpaid bills against estates of debtors
- Maintained and updated collections tracking spreadsheet to help organize payment information
- Precisely evaluated and verified benefits and eligibility
Insurance Verification Specialist, Re-Authorization Specialist, Prior Authorization Specialist
McKesson
03.2012 - 05.2013
- Evaluated patients' financial status and established appropriate payment plans
- Accurately posted and sent out all medical claims
- Posted and adjusted payments from insurance companies
- Maintained and updated collections tracking spreadsheet to help organize payment information
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls to ensure proper payments made according to contracts
- Located errors and promptly refiled rejected claims
- Communicated effectively and extensively with other departments to resolve claims issues
- Printed and reviewed monthly patient aging reports and for overdue payments
- Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy
Education
Diploma Medical Billing/Coding - Billing And Coding
American Career College
CA01.2009
High School Diploma -
Culver City Adult School
01.2007
Skills
- MEDICAL TERMINOLOGY
- Documentation review
- 40 WPM
- Prior authorization processing
- ICD-9/ICD-10
- Insurance
- Knowledgeable of BILLING SOFTWARE
- Claim review
- Information gathering
- HIPAA
- EDI
- Medical bill auditing
- Coding
- Customer service
- Accounts payable and receivable
- Windows
- CPT
- Claims processing
- Patient Account Auditing
- Insurance coverage verification
- Basic math skills
- Medical Billing
- Front desk
- Appeal/Reconsideration
- Office experience
- Patient contact
- Account follow-up
- Computer skills
- Spreadsheet
- Policies
- CMS-1500 billing forms
- Accounts payable
- Documentation
- Provider Contractual Agreement with Payers
- Insurance Sales
- LICENSED NOTARY
- Goal oriented
- Insurance claims
- Appeals handling
- Data entry proficiency
- Documentation management
- Medical appeals handling
- Call handling
- Call center experience
- Electronic claims
- Coverage and authorizations
- Insurance verification
- Healthcare industry
- Script adherence
- Communication and interpersonal skills
- Billing and collection procedures
- Policy evaluation
Timeline
Medicare Sales Agent
UHC - United Health Care Group
08.2022 - Current
Insurance Phone Rep/Collector
Orthoarizona Foot And Ankle Institute
10.2020 - 08.2022
Medical Biller/Collector
Harmony Medical Care
01.2020 - 05.2020
Reimbursement Specialist III
Dexcom Inc
06.2017 - 07.2019
Insurance Verification Specialist
Simon Med Imaging
05.2016 - 06.2017
Insurance Verification Specialist
A/R Ironwood Cancer Research
05.2015 - 04.2016
Medical Billing Specialist
Momdoc Women for Women
02.2014 - 04.2015
Insurance Verification Specialist, Re-Authorization Specialist, Prior Authorization Specialist
McKesson
03.2012 - 05.2013
Diploma Medical Billing/Coding - Billing And Coding
American Career College
High School Diploma -
Culver City Adult School
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