Denial Audit Specialist - Ensemble Health Partners - Blue Ash, OH
(2026-01)
- EIQ System, Epic and Availity portal
- Audit commercial insurance denials.
- Routed commercial insurance denials to the appropriate CDI (Nurse), Coding, or RI (Revenue integrity department).
- Submitted appeals, via email, via fax, or commercial insurance portals.
- Utilize EIQ system, action logs, IR (initial returns).
- Assigned Client folders.
- Communicate with Leadership, Smart team to resolve or expedite unresolved issues via teams or via email.
- Follow-up on commercial insurance denials/appeals/ medical records regarding determination letters.
- Assigned policy techs.
Medical Billing Analyst - Midwest Vascular & Varicose Veins Center - Holland, OH
(2025-07 - 2026-01)
- Practice Fusion, AdvancedMD, Veradigm/PayerPath system.
- Enter patients' information into the AR report to record insurance payments and patients' outstanding balances.
- Billed out office, ultrasounds and procedure visits to the appropriate insurance company.
- Verify the patient's insurance benefits and estimated /explanation of benefits.
- Enter patients' insurance payments, copays, deductibles and coinsurances in patients account/ Veradigm portal as needed.
- Submit /fax requested medical records(documents) to insurances as needed for medical necessity.
- Call insurance companies to check claim status and dispute denials.
- Maintain and prepare AR reports for management and the provider to review.
- Resolve patient's payments that have not been posted on the payment portal.
- Reach out to patients on the resolution of billing questions or payments.
- Update provider credentials information for revalidation as needed.
Senior Insurance Follow-up Specialist - University Of Toledo Physicians - Toledo, OH
(2021-10 - 2025-05)
- Athena and EPIC billing system.
- Utilize Avality portal, Paramount and Anthem portal to check claim status and verify patient eligibility.
- Submit disputes (Appeals) and correspondence and utilize insurance chat as needed.
- Compiled data for billing personnel.
- Expedited communication between upper-level management and Supervisors.
- Paramount, Commercial insurance and Anthem Commercial claims.
- Call and verify on accounts that need appeal or to get resolution.
- Fax appeals and medical records as needed for the payer.
Audiology Patient Care Specialist - Mobile Care Group - Sylvania, OH
(2020-01 - 2020-03)
- Ordering hearing aids.
- Proficient with hearing aid needs.
- Full knowledge of insurance websites.
- Communicating well with customers and employees.
- Following and scheduling patient's appointments.
- Able to prioritize and manage time.
- Prepared and maintained reports for management review.
- Maintaining good communication with billers and collection coordinators.
AR MI Optical Medical Billing/ Collection - Mobile Care Group - Sylvania, OH
(2013-07 - 2020-01)
- Proficient with Advanced billing system.
- Full knowledge of insurance websites.
- Communicate well with customers and employees.
- Follow HIPPA guidelines.
- Prioritized and managed time.
- Prepared and maintained reports for management review.
- Reviewed and recognized denial issues on patient's accounts.
- Maintained good communication with the biller and collection coordinator.
- Submitted HCFA 1500 claims to MI Medicare, MI Medicaid and MI Commercial Insurances.
- Resubmitted claims and submitted the necessary medical appeals.
AR Transportation Collection Specialist - Accountemps Services - Maumee, OH
(2011-03 - 2011-08)
- Prioritized and managed time.
- Prepared and maintained reports for management review.
- Reviewed and recognized denial issues or incorrect patient or insurance information on accounts.
- Maintained good communication with the biller and collection coordinator.
- Submitted HCFA 1500 claims to MI Medicare, MI Medicaid and MI Commercial Insurances.
- Resubmitted claims or submitted the necessary appeals or medical documentation to correct the claim denied.
- Take patient calls to resolve billing issues along with contacting insurance companies for denial.
- Able to bill in the necessary portals for claim payments through Advanced Billing System.
- Willing to take on additional responsibilities.
- Pull daily spreadsheets for payment status, bill out carriers / customer's invoices.
- Report possible credit holds for accounts 90 and above past due.
- Build relationships with customers for service.
- Daily follow- up & mailed invoices, POD (Purchase of delivery), re bills (resubmit) as needed.
- Call and email customers regarding past due accounts.
- Document records and follow up with clinicians of missing information in a timely manner.
- Pulled face sheets and medical records as requested.
- Batched incoming commercial payments.
- Misys billing system.
- Medicare electronic posting.
- Evaluating EOB (Explanation of benefits).
- Submitted remaining balance to secondary, third-party insurance and patients.
- Enter information into the system to record customers' outstanding balances.
