La'Dasha Tolbert

Healthcare revenue cycle professional with 8+ years of experience across hospital, physician, and speech therapy billing, claims resolution, denials, accounts receivable, and payer reimbursement. Demonstrated billing team leadership supporting 6–10 employees, including daily work assignments, new-hire training, claim escalation review, and KPI/productivity monitoring. Experienced in processing 100+ claims daily, Epic workflows, payer compliance, and Medicare, Medicaid, and commercial insurance requirements.

Prepared to bring operational oversight and process improvement experience to a medical billing management role.

Contracting & Credentialing Specialist - Expressable Speech Therapy - Remote

(2023-07)

• Manage multi-state payer contracting and credentialing workflows, submissions, follow-ups, and documentation to support revenue cycle readiness.
• Analyze agreements, amendments, fee schedules, reimbursement methodologies, effective dates, and payer obligations to support accurate billing setup.
• Coordinate with payers and internal teams on enrollment, EDI, EFT/ERA, portals, and reimbursement-related operational issues.

Payer Compliance Specialist - Expressable Speech Therapy - Remote

(2023-07)

• Review payer policies and claims requirements; translate Medicare, Medicaid, and commercial updates into actionable billing guidance.
• Analyze denial trends, documentation gaps, and authorization issues; partner with revenue cycle teams to improve claim resolution.
• Support audit readiness, payer setup, fee schedule accuracy, and standardized reference materials.

Billing Team Lead / Medical Billing Coordinator - Expressable Speech Therapy - Remote

(2023-07)

• Coordinated daily workflows for 6–10 billing employees, assigned and prioritized work queues, and trained new hires on billing processes, claim accuracy, and payer requirements.
• Processed and followed up on 100+ claims daily; resolved rejected and denied claims through payer research, corrections, appeals, and resubmissions.
• Monitored productivity and billing KPIs, reviewed claims for accuracy, and managed escalated issues to support timely follow-up and consistent quality.
• Supported accounts receivable, payment posting, refunds, credit balances, and reconciliations; partnered with revenue cycle leadership on billing quality and workflow improvements.

Claims Manager - HCA Parallon Workforce Solutions - Remote

(2021-11 - 2023-08)

• Supported hospital billing and facility revenue cycle operations in Epic, including insurance follow-up, claim status, denials, coding edits, recoupments, refunds, and accounts receivable resolution.
• Reviewed hospital claims, EOBs, billing edits, and reimbursement discrepancies; processed adjustments and corrected primary and secondary claims.
• Worked Medicare, Medicaid, and commercial payer accounts while meeting established productivity and quality expectations.

Lead Claims Representative - Zotec Partners - Remote

(2017-10 - 2021-11)

• Supported multiple medical billing types and workflows, including physician/professional and laboratory claims, primary and secondary insurance billing, payment reallocations, adjustments, refunds, and insurance updates.
• Resolved complex claims across Medicare, Medicaid, and commercial insurance billing; managed escalations and mentored colleagues on payer follow-up, claims workflows, and HIPAA compliance.

Bachelor’s Degree - Business Administration - Western Governors University