Summary
Overview
Work History
Education
Skills
Timeline
background-images

Whitney Davis

Johnson City,TN

Summary

Dynamic IDR Claims Specialist at with a proven track record in healthcare billing and claims processing. Leveraged strong decision-making and attention to detail to reduce errors and enhance efficiency, achieving financial targets through effective claims resubmission. Committed to maintaining compliance and optimizing workflows for improved productivity.

Overview

9
9
years of professional experience

Work History

IDR Claims Specialist

QMACS
03.2024 - 04.2025
  • Effectively managed high volume of claims by prioritizing tasks and showcasing strong organizational skills.
  • Applied negotiation and critical thinking to settle complex claims fairly and accurately.
  • Conducted detailed investigations to reduce claim processing errors through precise policy interpretation.
  • Enhanced efficiency by streamlining workflows and implementing strategic time-saving measures.
  • Achieved financial targets by resubmitting edited claims after addressing denials and outstanding debts.
  • Processed and updated existing policies to maintain compliance with current standards.
  • Oversaw a portfolio of high-value claims, emphasizing detail-oriented management and policy adherence.
  • Ensured accuracy of claim documents through thorough reviews, securing missing data for settlements.

IDR Resolution Specialist

J29
06.2023 - 02.2024
  • Enhanced future case handling efficiency by meticulously maintaining records of interactions and resolutions.
  • Utilized strong organizational skills to manage high volume of claims through effective task prioritization.
  • Decreased claim processing errors by executing thorough investigations and interpreting policies accurately.
  • Updated claim files regularly to guarantee timely submission of required documentation.
  • Resubmitted adjusted or denied claims to align with financial objectives and decrease outstanding debt.
  • Reviewed claim documents for compliance and accuracy, thereby lowering potential financial losses.
  • Collaborated with cross-functional teams to optimize claims handling procedures, resulting in improved productivity.

Medical Data Reviewer

Remedy Staffing Agency
10.2016 - 03.2023
  • Enhanced patient data accuracy by meticulously reviewing and verifying medical records.
  • Supported medical staff by providing organized and accurate medical records.
  • Identified discrepancies in medical data, initiating timely resolutions and maintaining high-quality standards.

Education

Bachelor of Science - Physician Assistant

Jefferson College of Health Sciences
Roanoke, VA
08-2006

Skills

  • Healthcare billing
  • Claims processing
  • Documentation review
  • Claims analysis
  • Time management
  • Settlement management
  • Decision-making
  • Attention to detail
  • Organizing and prioritizing work
  • Claims investigation

Timeline

IDR Claims Specialist

QMACS
03.2024 - 04.2025

IDR Resolution Specialist

J29
06.2023 - 02.2024

Medical Data Reviewer

Remedy Staffing Agency
10.2016 - 03.2023

Bachelor of Science - Physician Assistant

Jefferson College of Health Sciences

Similar Profiles

CREATE PROFILE
Whitney Davis