Tosha Allen
Laurens,SC
Summary
Experienced and detail-oriented Medical Billing Specialist with 6 years of expertise in managing the end-to-end processing of BLS ambulance claims. Skilled in insurance verification, coding, claim submission, and follow-up to ensure accurate reimbursement. Adept at handling claim denials and underpayments, improving billing workflows, and maintaining compliance with healthcare regulations. Background in medical assisting and military service, fostering strong attention to detail, problem-solving skills, and an ability to work efficiently in high-pressure environments.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Ambulance Medical Billing Specialist
Valor Medical Services
01.2019 - 02.2025
- Managed end-to-end processing of medical claims, ensuring accuracy and timely submission to insurance companies
- Verified patient insurance coverage and obtained necessary authorization for services before claim submission
- Accurately applied medical codes (CPT, ICD-10, HCPCS) to claims, ensuring proper documentation and compliance with payer requirements
- Followed up on outstanding claims, resolved denials, and worked with insurance providers to correct coding errors and secure reimbursements
- Managed patient accounts, ensuring accurate posting of payments, adjustments, and balance resolutions
- Maintained compliance with HIPAA regulations, ensuring the confidentiality and security of patient data
- Generated and reviewed billing reports to identify discrepancies, ensure accuracy, and improve claim processing efficiency
Military Service
Navy
09.2008 - 01.2014
- Developed leadership, record-keeping, and operational skills in a structured environment
- Managed documentation and ensured compliance with military regulations
- Led training efforts and mentored personnel in the implementation of standard procedures
Education
Associate of Applied Science - Medical Assisting
ECPI
04.2016
Skills
- End-to-End Claims Processing
- Medical Billing & Coding
- Insurance Verification & Reimbursement
- Claims Management & Follow-Up
- HIPAA Compliance
- Patient Account Management
- Billing System Proficiency
- Problem-Solving
- Time Management
- Data Entry & Accuracy
- Proficient in ESO and Availity medical billing software
- Knowledge of ICD-10, CPT, and HCPCS coding systems
- Strong attention to detail and organizational skills
- Excellent communication and customer service abilities
- Knowledge of HIPAA regulations and healthcare compliance standards
Certification
- Certified Ambulance Coder (CAC)
- Certified Ambulance Compliance Officer (CACO)
Timeline
Ambulance Medical Billing Specialist
Valor Medical Services
01.2019 - 02.2025
Military Service
Navy
09.2008 - 01.2014
- Certified Ambulance Coder (CAC)
- Certified Ambulance Compliance Officer (CACO)
Associate of Applied Science - Medical Assisting
ECPI
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