Tanisha Cobbs
Houston,TX
Summary
Metrix performing Billing Specialist with experience in healthcare billing, coding, and insurance regulations, particularly with Medicare and Medicaid. Expert in charge capture, ICD/CPT/HCPCS coding, and conducting root cause analysis for claims adjudication. Seeking Billing Specialist role to leverage extensive background in revenue cycle processes and customer service excellence.
Overview
12
12
years of professional experience
Work History
Medicare Billing Specialist
St Joseph Medical Center
Houston, TX
06.2024 - Current
- Ensures accuracy and appropriateness of bill type, diagnosis codes, place of service, procedure codes, HCPC or NDC and proper use of modifiers for dates of service
- Certifies the accuracy and completeness of payer requirements prior to timely submission of clean claims
- Manages Billing que status code to track unbilled delivery ticket(s) to maintain Reimbursement report
RCO Adjudication Billing Specialist
PharmScript
Katy, Tx
11.2019 - 06.2024
- Analyzed and resolved adjudication issues to ensure accurate insurance claim payments, enhancing compliance with Medicare and Medicaid regulations.
- Streamlined charge capture and coding processes using ICD, CPT, and HCPCS systems, improving billing accuracy and efficiency.
- Managed appeals and provided customer service, addressing and correcting billing discrepancies and enhancing client satisfaction.
Certified Pharmacy Technician
CVS Caremark/Aetna Insurance
Hou, TX
04.2014 - 10.2019
- Served as the initial point of contact for pharmacy inquiries, verifying insurance coverage and eligibility for patients.
- Processed prior authorization requests by applying standardized criteria, ensuring accurate determination of pharmacy benefits using medical terminology and coding.
- Conducted thorough clinical reviews incorporating lab results, drug history, and medical records to establish and approve prior authorizations.
Education
Associate Degree -
Houston Community College
08.2013
Timeline
Medicare Billing Specialist
St Joseph Medical Center
06.2024 - Current
RCO Adjudication Billing Specialist
PharmScript
11.2019 - 06.2024
Certified Pharmacy Technician
CVS Caremark/Aetna Insurance
04.2014 - 10.2019
Associate Degree -
Houston Community College
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