Denials Management Specialist - Beth Israel Lahey Health - Burlington, MA
(2023-09)
- Managed medical claim denials and appeals to support timely reimbursement.
- Investigated denial root causes and coordinated claim corrections with billing teams.
- Reconciled outstanding claims and tracked follow-up activity across accounts.
- Communicated with insurance carriers to clarify denial reasons and secure payment.
- Maintained accurate denial records in Epic while following HIPAA and billing compliance standards.
Insurance Verification Specialist - New England Life Care - Woburn, MA
(2020-12 - 2023-02)
- Verified insurance eligibility and benefits for new patient referrals within required timelines.
- Negotiated with third-party payers to establish pricing for home infusion therapies.
- Coordinated with branch teams to support timely patient care and account setup.
- Prepared financial responsibility documents and explained coverage details to patients.
- Entered patient accounts accurately and documented insurance information in billing systems.
Billing Specialist - Epoch Sleep Centers - Lincoln, RI
(2018-01 - 2018-10)
- Processed insurance verification and obtained prior authorizations for patient cases.
- Reviewed explanation of benefits to support accurate billing and claim resolution.
- Responded to patient billing inquiries and applied account credits when needed.
- Assigned daily work and target dates to support timely team completion.
- Worked with referrals, scheduling, and documentation to maintain billing accuracy.
Insurance Authentication Specialist - All Care plus Pharmacy - Northborough, MA
(2017-03 - 2017-07)
- Completed prior authorizations to move patient cases through the approval process.
- Researched benefit issues and checked appeal status with payers and providers.
- Verified copay assistance and coverage details with insurance companies.
- Supported timely case processing through accurate documentation and follow-up.
Insurance Verification Specialist - UMass Memorial Medical Center - Worcester, MA
(2016-05 - 2016-12)
- Verified eligibility and benefits for patient insurance policies.
- Contacted patients to obtain missing policy details and resolve billing restrictions.
- Researched denial reason codes with insurance companies and billing teams.
- Generated referral numbers and submitted referral request letters when needed.
- Analyzed explanation of benefits to support claim investigation and correction.
