Hi, I’m
T-ata DeHart
Missouri City,TX
Summary
Experienced in effectively managing appeals and dispute resolution processes. Utilizes strong analytical skills to assess and resolve complex cases while maintaining compliance with regulatory standards. Demonstrated track record of collaborating with teams to deliver timely and accurate outcomes. Adapts seamlessly to changing needs and requirements.
Overview
13
years of professional experience
Work History
Altus Biologics
Sr. Appeals Specialist II
12.2021 - Current
Job overview
- Prepared appeals to the payor specifications, i.e
- Dispute forms and/or any documentation for dispute and copy of patient's medical record to support medical necessity denials
- Responsible for collection efforts on accounts receivable as assigned by the Revenue Cycle Director
- Responsible for claim progress by using every available avenue, such as online tools, automated systems, and payor representatives
ROUNDTABLE MEDICAL CONSULTANTS
Insurance Reimbursement Specialist
05.2018 - 12.2020
Job overview
- Initiated collection follow-up on all unpaid or denied claims with appropriate insurance carrier by researching, sending appeal letters, and resolving unpaid insurance claims
- Followed up on claims submitted to ensure prompt and timely payment and verify that claims submitted were received and are in processing
- Sent letters to the patient or responsible party when their insurance carrier failed to make payment in a reasonable time frame
YOUR CHOICE HOME HEALTH
Billing Specialist
03.2012 - 05.2017
Job overview
- Specialized in billing commercial, Medicaid, and Medicare claims
- Researched denied claims, wrote appeals which resulted in substantial revenue recoupment
- Provided principal office support including processing incoming home health referrals
Education
UNIVERSITY OF PHOENIXHouston, TX
Bachelor of Science from Accounting
10.2015
GENESIS VOCATIONAL TRAININGHouston, TX
Medical Assistant from Billing & Coding
08.2004
Skills
- Organizational growth
- HIPAA compliance
- Effective communication
- Professionalism and ethics
- Appeals process proficiency
- Insurance policies
- Attention to detail
- Critical thinking
- Excellent communication
- Organizational skills
- Insurance claim forms review
Timeline
Sr. Appeals Specialist II
Altus Biologics
12.2021 - Current
Insurance Reimbursement Specialist
ROUNDTABLE MEDICAL CONSULTANTS
05.2018 - 12.2020
Billing Specialist
YOUR CHOICE HOME HEALTH
03.2012 - 05.2017
GENESIS VOCATIONAL TRAINING
Medical Assistant from Billing & Coding
UNIVERSITY OF PHOENIX
Bachelor of Science from Accounting
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