Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Valerie Brooks-Lewis

Marana,AZ

Summary

Results-driven Medical Billing Specialist with expertise in ICD-10 and appeals management at Retina Associates. Proven track record in enhancing collections performance and resolving discrepancies, while demonstrating strong insurance verification skills. Adept at analyzing claims to ensure timely reimbursements, fostering effective communication with patients and insurers to optimize account resolution.

Overview

17
17
years of professional experience
1
1
Certification

Work History

Medical Billing Specialist

Retina Associates
Tucson, AZ
09.2023 - Current
  • Monitor Blue Cross accounts receivables, Blue Cross changes to ensure compliance.
  • Initiated collection efforts on unpaid accounts by contacting insurance companies or patients directly via phone or mail.
  • Submitted appeals for denied claims when appropriate according to the insurance company's criteria.
  • Analyzed rejected claims and corrected errors as necessary before resubmitting them for payment.
  • Resolved discrepancies between insurance companies and patients regarding payment of bills.
  • Developed strategies for improving collections performance while reducing bad debt write-offs.
  • Monitored aging accounts receivable balances ensuring timely resolution of outstanding balances.

Collections Specialist Remote

Salibas Pharmacy
Oro Valley, Arizona
10.2022 - 05.2023
  • Ensured accurate billing and timely submission of electronic and/or paper claims
  • Monitored claim status and researched rejections and denials
  • Documented related account activities
  • Made outgoing calls to insurers, responsible parties, and others to follow up on rejected claims and garner accurate insurance information
  • Obtained correct patient demographics for accurate prescription delivery
  • Made collection calls for outstanding invoices
  • Ensured invoices were sent to facilities for correct cycle fill

Revenue Cycle Specialist II FQHC Remote

Legacy Community Health Services FQHC
Houston, TX
12.2017 - 04.2022
  • Responsible for all aspects of account follow up and collections; ensure that all billing is sent/transmitted and that payments or reimbursements are received promptly, including processing appeals
  • Works with payers to determine reasons for denials, corrects and reprocesses claims for reimbursement on time
  • Ability to analyze accounts and determine following appropriate action for account resolution
  • Reviews explanation of benefits (EOBs) to ensure proper reimbursement of claims and reports any problems, issues, or payer trends
  • Collaborates with management to reduce aging of accounts by providing verbal and written communication
  • Verify patient's insurance coverage and obtain preauthorization and referrals as needed

Medical Collections Specialist Commercial

Fannin Surgicare (HCA Healthcare)
Houston, TX
01.2015 - 12.2017
  • Analyzing patient's accounts for proper payments, resubmitted corrected claims to carriers
  • Knowledgeable in accounts receivable follow-up, verifies insurance eligibility and benefits and ensures all notifications and authorizations are completed within the required timeframes
  • Familiar with clearing manual and electronic rejections and edits to expedite the claims cycle
  • Make insurance and patient collection calls, obtained referrals for the specialist, worked denials, and sent appeals
  • Back up to front desk registration, posted patient payments, and process patient and insurance refunds

Medical Biller / Collections Specialist

Northwest Family Practice
Houston, TX
02.2012 - 01.2015
  • Strong Working Knowledge of Electronic billing, CPT and ICD-9 coding, EOBs, and insurance plans such as Medicare, Medicare replacement plans, Medicaid HMOs, PPOs, and other Commercial payors
  • Review claims to verify payments are made according to the fee schedule and contractual adjustments are taken appropriately
  • Collections inbound and outbound calls, resolve denials as they appear, document clean concise follow up notes in system for each account worked
  • Work monthly aging report to keep AR current, communicating with patients to help them resolve their healthcare accounts, setting payment expectations, arranging payments and requesting information from patients

Medical Collections Specialist Government

Fannin Surgicare (HCA Healthcare)
Houston, TX
01.2008 - 02.2012
  • Analyzing patient's accounts for proper payments, works unpaid and rejected claims, performing account follow-up and resolution of insurance and patient receivables
  • Work insurance pools and contact insurance companies to resolve claims that are not paid in a timely manner
  • Review EOB's, remits and payer correspondence performing account follow-up and escalate any identified issues to the appropriate area for review and response to expedite claim resolution
  • Document in the patient account record to identify actions taken on the account, and check status of claims and file appeals as needed

Education

High School Diploma -

John Harris High School
Harrisburg, PA

Skills

  • Insurance verification and authorizations
  • ICD-10 proficiency
  • Medical terminology expertise
  • Appeals management and resolution

Certification

  • Certified Notary Public
  • Medical Billing Certification

Timeline

Medical Billing Specialist

Retina Associates
09.2023 - Current

Collections Specialist Remote

Salibas Pharmacy
10.2022 - 05.2023

Revenue Cycle Specialist II FQHC Remote

Legacy Community Health Services FQHC
12.2017 - 04.2022

Medical Collections Specialist Commercial

Fannin Surgicare (HCA Healthcare)
01.2015 - 12.2017

Medical Biller / Collections Specialist

Northwest Family Practice
02.2012 - 01.2015

Medical Collections Specialist Government

Fannin Surgicare (HCA Healthcare)
01.2008 - 02.2012

High School Diploma -

John Harris High School

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Valerie Brooks-Lewis