Victoria Wade
Mesquite,TX
Summary
Ambitious Customer Service professional offering excellent supervisory and performance-assessment skills. Versed in pacifying dissatisfied customers and utilizing effective listening skills. Proven history of reliability, professionalism and conflict resolution.
Overview
9
9
years of professional experience
Work History
Eligibility Representative
Accredo Pharmacy (Cigna)
04.2025 - Current
- Verified patient eligibility and insurance coverage for specialty medications across multiple payers, ensuring accurate benefits determination and reducing claim denials.
- Processed benefits investigations, prior authorizations, and coverage reviews in compliance with Accredo and payer-specific requirements.
- Communicated with patients, providers, and insurance carriers to resolve eligibility discrepancies and clarify coverage details in a timely manner.
- Entered and updated patient insurance information with a high degree of accuracy, maintaining compliance with HIPAA and internal quality standards.
- Identified and escalated complex coverage issues, coordinating with pharmacy operations, billing, and clinical teams to expedite patient access to therapy.
- Utilized systems such as MedAccess, Salesforce, AS400, and PrimeRx to document eligibility findings and manage workflow queues.
- Achieved productivity, accuracy, and service-level goals through efficient handling of high-volume eligibility and benefits verification tasks.
- Educated patients on financial responsibility, copay structures, and available assistance programs to support successful therapy starts.
- Reviewed claim rejections related to eligibility and collaborated with billing teams to correct errors and resubmit claims.
- Supported onboarding of new patients by completing insurance verification within required turnaround times, enabling timely medication dispensing.
Account Manager (Accounts Receivable)
AER Manufacturing
Addison, Texas
06.2024 - 02.2025
- Tracked and reported on sales performance metrics to senior management, highlighting successes and areas for improvement.
- De-escalated customer interactions by providing alternative solutions to issues.
- Presented product features and advantages to potential customers during sales meetings.
- Assisted in developing and updating accounts receivable procedures.
- Maintained detailed records of all accounts receivable transactions.
- Processed monthly payments and researched payment discrepancies.
- Reconciled or entered report discrepancies found in financial records.
- Issued monthly statements to clients and followed up on outstanding payments.
- Maintained accurate records of accounts receivable and payable transactions.
- Worked closely with internal teams to resolve customer billing and payment issues.
- Processed invoices, credit memos, and other documents related to accounts receivable.
- Updated vendor files with new contact information or changes in payment terms upon request.
- Performed various accounts receivable functions, handled cash receipts posting, updated cash flow reports and researched chargebacks and write-offs.
- Verified accuracy of invoices and account balances.
- Reconciled bank statements on a regular basis to ensure accuracy of financial records.
- Processed new customer forms to set up accounts in system.
- Updated accounting notes in CRM, maintaining pertinent credit information.
- Negotiated payment plans with delinquent accounts.
- Collaborated with sales team members to ensure timely collection of outstanding debts from customers.
Billing Team Lead (Supervisor)
Optum/ Quest Diagnostics
Dallas, TX
10.2022 - 05.2024
- Directed a team of 17 associates, handling 70+ calls per day, ensuring efficient resolution of medical billing and insurance-related issues.
- Trained and mentored new employees on medical billing procedures, customer service best practices, and company protocols.
- Managed daily operations including scheduling, task assignments, and performance reviews, maintaining focus on team goals and patient account resolution.
- Ensured accuracy of accounts receivable transactions, including processing invoices, credit memos, and insurance payments.
- Analyzed medical coding issues, identified errors, corrected them, and followed up with insurance providers on denied claims to secure payments.
- Audited patient files for accuracy before submitting claims to ensure compliance with healthcare regulations and maximum reimbursement.
- Tracked aging reports and managed the follow-up of delinquent accounts, ensuring timely payments and resolution of outstanding balances.
- Applied HIPAA regulations to maintain confidentiality and security of patient billing information.
- Worked closely with internal departments to resolve customer billing inquiries, disputes, and payment issues.
Claims Adjuster
Alacrity Solutions (Worley Catastrophe)
Richardson
07.2021 - 02.2022
- Conducted interviews with claimants, witnesses and medical professionals to obtain additional information about the claim.
- Ensured timely follow-up on all open matters; kept stakeholders informed regarding status updates.
- Investigated insurance claims, reviewed coverage and liability, prepared reports and recommended payment or denial of claims.
- Adhered strictly to departmental guidelines; ensured that all activities were compliant with applicable state laws.
- Maintained accurate documentation of all claim activity within designated system.
- Performed special projects upon request from management; completed tasks efficiently while meeting deadlines.
- Utilized claim handling software to document and manage claim files efficiently.
Billing Specialist II
Baylor Scott & White
Dallas, TX
04.2017 - 09.2021
- Managed accounts receivable for 100+ client accounts, ensuring timely payment of invoices and maintaining accurate billing records.
- Verified insurance coverage and worked with third-party payers to facilitate accurate billing, addressing issues such as authorization and payment discrepancies.
- Contacted insurance companies for billing authorization, pre-certification, and pre-authorization, ensuring full compliance with insurance requirements.
- Monitored accounts receivable activity and tracked aging reports to manage collections and reduce outstanding balances.
- Assisted patients with payment plans, refunds, and billing inquiries, ensuring customer satisfaction while adhering to company policies.
- Processed and tracked medical invoices, credit memos, and other financial documents related to accounts receivable.
- Trained and supported new staff on billing procedures, software systems, and effective customer service techniques.
- Managed insurance claim submission processes and followed up with providers on denials or incorrect billing codes.
- Developed financial reports on aging accounts, billing adjustments, and payment statuses for management review.
Education
High School Diploma -
North Mesquite High School
Mesquite, TX05.2011
Skills
- Corporate processes and procedures
- Accounts Receivable
- Call Center Operations
- Microsoft Office expertise
- Employee coaching
- Inbound and Outbound Calling
- Quality assurance controls
- Account Management
- Client Engagement
- Sales
- Customer Relations
- Medical terminology knowledge
- Payment Processing
- Payment posting
Licensing
- All-Lines Insurance Adjuster, License Number 2616651, Covey Inspection Services
Timeline
Eligibility Representative
Accredo Pharmacy (Cigna)
04.2025 - Current
Account Manager (Accounts Receivable)
AER Manufacturing
06.2024 - 02.2025
Billing Team Lead (Supervisor)
Optum/ Quest Diagnostics
10.2022 - 05.2024
Claims Adjuster
Alacrity Solutions (Worley Catastrophe)
07.2021 - 02.2022
Billing Specialist II
Baylor Scott & White
04.2017 - 09.2021
High School Diploma -
North Mesquite High School