Summary
Overview
Work History
Education
Skills
Timeline
Generic

Valerie Compton

Pittsburgh,PA

Summary

I have a proven track record in customer service and claim submission, enhancing client satisfaction and reducing claim denials by implementing meticulous verification processes. My experience in accounts receivable management and ability to foster positive relationships have significantly contributed to operational efficiency and client loyalty.

Experienced with benefit verification processes and insurance coordination. Utilizes effective communication skills to resolve benefit discrepancies and support patient needs. Knowledge of regulatory guidelines and insurance protocols, ensuring compliance and accuracy in all verifications.

Overview

14
14
years of professional experience

Work History

Independent Travel Agent

InteleTravel
02.2023 - Current
  • Organized group tours, managing logistics and ensuring a seamless travel experience for all participants.
  • Increased repeat business by building strong relationships with clients through excellent customer service.
  • Provided timely assistance to travelers in need, resolving issues promptly and professionally.
  • Conducted thorough research on destinations, accommodations, and attractions to provide well-informed advice to clients.
  • Assisted corporate clients with arranging business travels including flights, hotels, ground transportation arrangements.
  • Maintained accurate records of client bookings to ensure proper billing and commission tracking.
  • Supervised payments via credit and debit cards and handled sensitive information with professionalism and discreteness.

Retired

CVS Caremark Specialty Pharmacy
12.2020 - 02.2023

Benefit Verification Specialist

CVS Specialty Pharmacy
11.2015 - 12.2020
  • Maintained up-to-date knowledge of insurance regulations, enabling accurate benefit verifications for various plans.
  • Improved patient satisfaction by accurately verifying benefits and providing timely responses to inquiries.
  • Managed high-volume caseloads while maintaining strict deadlines for completing benefit verifications and authorizations.
  • Prepared and processed medical claims, ensuring accuracy and compliance with insurance policies.
  • Reduced claim denials with thorough insurance eligibility assessments prior to service provision.

Medical Biller, Accounts Receivable

Wallgreens
04.2013 - 11.2015
  • Ensured accurate coding and billing practices, resulting in reduced claim rejections and faster reimbursements.
  • Provided exceptional customer service while addressing patient inquiries regarding billing issues or concerns.
  • Maintained confidentiality of patient information by adhering to strict HIPAA regulations throughout the billing process.
  • Implemented quality assurance measures to minimize errors in data entry, leading to increased claim approval rates from insurers.
  • Facilitated clear communication between medical providers, insurance companies, and patients for smooth billing operations.
  • Reduced account receivables aging through diligent follow-up on outstanding claims and prompt resolution of denials.
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
  • Delivered timely and accurate charge submissions.
  • Posted payments and collections on regular basis.
  • Collected payments and applied to patient accounts.
  • Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
  • Verified insurance of patients to determine eligibility.

Medical Biller and Coder

Dr. Anita Onufer, Podiatrist
09.2010 - 04.2013
  • Reviewed patient charts to better understand health histories, diagnoses, and treatments.
  • Resourcefully used various coding books, procedure manuals, and on-line encoders.
  • Correctly coded and billed medical claims for various hospital and nursing facilities.
  • Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
  • Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
  • Ensured continuous improvement in billing processes through regular audits of medical codes and charge entries for accuracy.
  • Worked closely with physicians to accurately assign ICD-10 diagnostic codes for optimal reimbursement rates from insurance companies.
  • Reduced claim denials through meticulous verification of patient eligibility and coverage benefits prior to claim submission.
  • Increased accuracy in medical claims submissions by conducting thorough reviews of patient records and insurance information.
  • Expedited payment processing by promptly addressing any discrepancies or issues raised by insurance carriers.
  • Assisted patients with understanding their insurance coverage and financial responsibilities, fostering positive relationships and trust between the practice and its clients.
  • Contributed to team efficiency by maintaining organized records of patient accounts, billing statements, and payment statuses.

Education

Associate of Science - Environmental Science

Pittsburgh Technical College
Pittsburgh, PA
06-1982

High School Diploma -

General Braddock Sr. High
North Braddock, PA
06-1978

Skills

  • Claim submission
  • Collections experience
  • Patient account management
  • Customer service
  • Billing and collection procedures
  • Electronic claims
  • Insurance claims processing
  • CMS-1500 billing forms
  • Accounts receivable management
  • Payment posting

Timeline

Independent Travel Agent

InteleTravel
02.2023 - Current

Retired

CVS Caremark Specialty Pharmacy
12.2020 - 02.2023

Benefit Verification Specialist

CVS Specialty Pharmacy
11.2015 - 12.2020

Medical Biller, Accounts Receivable

Wallgreens
04.2013 - 11.2015

Medical Biller and Coder

Dr. Anita Onufer, Podiatrist
09.2010 - 04.2013

Associate of Science - Environmental Science

Pittsburgh Technical College

High School Diploma -

General Braddock Sr. High

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Valerie Compton