Valantha Woodson
Nashville,TN
Summary
I would like the opportunity to show my leadership skills and set a professional example for advancement in the workplace.
Overview
10
10
years of professional experience
Work History
Revenue Cycle Specialist
Meduit RCM
03.2025 - Current
- Increase revenue by identifying and resolving billing errors in a timely manner.
- Ensure accurate billing with thorough audits of patient accounts and insurance claims.
- Reach out to insurance companies to verify coverage.
- Identify and resolved payment issues between patients and providers.
- Balance and reconcile accounts.
- Maintain clear documentation of all activities related to unpaid claims or denied services.
- Reduce outstanding account balances by implementing effective collection strategies.
- Successfully navigate complex insurance disputes, resulting in recovery of previously denied claims.
- Evaluate medical claims for accuracy and completeness and researched missing data.
- Contact insurance companies to resolve outstanding claim issues
- Provide carriers with information needed to process claims
- Payment posting, correct and resubmit claims, compose appeal letters
- Fix coding issues and billing mistakes, resubmit corrected claims, resolve outstanding balances
Medical Claims Representative
Frasier Healthcare and Consulting
02.2022 - Current
- I am available as needed for special projects, analyze claims, use payer portals
- Identify trends, review remits and EOB's, prepare and submit medical records
- Researched and resolved complex medical claims issues to support timely processing.
- Monitored and updated claims status in claims processing system.
- Contact insurance companies to resolve claim denials
- Verify patient eligibility, correct and resubmit claims
- Responded to correspondence from insurance companies.
- Identified and resolved discrepancies between patient information and claims data.
- Post adjustments, update insurance, transfer balances
- Handled complex claim issues, effectively communicating with patients, providers, and insurance companies to ensure resolution.
- Ensured prompt payment from insurance companies through diligent follow-up on outstanding claims balances.
- Demonstrated adaptability by handling various types of medical claims across multiple specialties while maintaining accuracy.
ROPS Revenue Operations Payment Specialist Level II
DaVita Kidney Care
01.2023 - 07.2024
- Researched balances on level two accounts, verified accuracy of information
- Identified trends, performed root cause analyst for unpaid, underpaid and overpaid claims
- Reviewed charges for kidney care, dialysis treatments and other services
- Worked multiple special projects, verified and processed refunds for credit balances
- Reversed charges, posted adjustments, verified retractions and correct balances owed with payers
- Reviewed ledger to correct balances, created refund packets, created retraction packets
- Hosted the weekly meeting, created team building activities for remote workers
- Managed the reconciliation of accounts payable and receivable, ensuring accuracy in financial reporting.
- Performed various administrative tasks related to payments, including generating reports, updating records, and maintaining accurate documentation.
- Reconciled accounts receivable ledger to verify payments and resolve variances.
- Researched billing errors and discrepancies to initiate corrective action.
Patient Account Representative
Accordias Healthcare Services
09.2017 - 02.2022
- A/R, assisted facilities with new and aging account balances, reviewed EOB’s, posted adjustments
- Claims follow up, exceeded daily and monthly collection goals, researched and reviewed claim denials
- Verified insurance, updated patient information, resolved insurance issues, screened and queued claims
- Corrected and resubmitted claims for payment resolved unpaid account balances
- Verified billing errors with payers, prepared medical records for submission, wrote appeal letters
- Identified denial trends for correction
- Thoroughly documented accounts for accuracy, faxed, copied, filed
- Typed patient letters for past due balances
- Determined write offs for aged balances based on denial
- Corrected coding issues on claims, added modifiers where needed
- Researched credit balances and overpayments, payment posting
- Reviewed insurance eligibility and verified coverage details to minimize claim denials and delays in payment.
- Promoted a positive work environment by actively participating in team meetings and contributing ideas for process improvements.
- Enhanced patient satisfaction by promptly addressing inquiries and resolving account issues.
- Identified trends in unpaid accounts, developing targeted solutions for improved revenue recovery.
- Maintained accurate records of all transactions, ensuring timely payments from patients and insurance providers.
- Researched billing errors and discrepancies to initiate corrective action.
Patient Account Representative Medical Insurance Collector
Xtend Healthcare Revenue Cycle Management
06.2015 - 04.2016
- Worked government and commercial accounts, assisted facilities with new and aging A/R
- Contacted patients for payment of insurance issues, identified charges for accurate claims billing
- Posted payments and adjustments
- Identified trends and billing errors, submitted corrected claims for payment, reviewed EOB’s
- Contacted insurance companies for resolution
- Worked denials and unpaid claims issues
- Determined write-offs and adjustments for aging balances
- Achieved consistent success in meeting or exceeding monthly collection targets, demonstrating commitment to organizational goals
- Efficiently trained new team members on best practices for medical insurance collections and relevant software applications
- Maintained accurate documentation of all collection activities, ensuring compliance with industry regulations and internal policies
- Expedited timely follow-ups on outstanding accounts, resulting in increased revenue for the organization
- Researched and resolved complex medical claims issues to support timely processing
- Verified patient insurance coverage and benefits for medical claims
- Monitored and updated claims status in claims processing system.
- Responded to correspondence from insurance companies
Education
Bachelor of Science - Communications
Tennessee State University
Nashville, Tennessee05-2006
Skills
- Claims review
- Claims processing proficiency
- HIPAA compliance
- Professionalism and ethics
- Insurance verification
- Verifying insurance
- Denial management
- Medical billing expertise
- Analytical problem solving
- Accounts receivable management
- Managing records
- Collecting payments
- Financial counseling
- Revenue cycle management
- Coordinating documents
- Records coordination
- Medical billing
- Payment posting
- Insurance collaboration
- Analyzing claims
- Teamwork
- Teamwork and collaboration
- Customer service
- Problem-solving
- Time management
- Attention to detail
PROFESSIONAL SUMMARY
I am proficient in the use of all Microsoft Applications including Word, Excel and Outlook. I am very customer service oriented. I possess leadership, managerial and supervisory skills with extreme attention to detail. I have excellent verbal and written communication skills along with great multitasking skills.
Timeline
Revenue Cycle Specialist
Meduit RCM
03.2025 - Current
ROPS Revenue Operations Payment Specialist Level II
DaVita Kidney Care
01.2023 - 07.2024
Medical Claims Representative
Frasier Healthcare and Consulting
02.2022 - Current
Patient Account Representative
Accordias Healthcare Services
09.2017 - 02.2022
Patient Account Representative Medical Insurance Collector
Xtend Healthcare Revenue Cycle Management
06.2015 - 04.2016
Bachelor of Science - Communications
Tennessee State University
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