Cherry L.
Mid-Level Healthcare Revenue Cycle Specialist
Open to offersNew to PlatformAbout
Cherry L. is a seasoned Claims Specialist with five years of experience in the healthcare industry, specializing in Revenue Cycle Management (RCM) for three years. Her expertise lies in eligibility verification, claim submission, denial management, and payment posting, ensuring smooth and accurate claim processing. At CBM Medical Management, Cherry is responsible for gathering and verifying patient information, handling billing issues with insurance companies, and adhering to HIPAA compliance and billing regulations. Her role demands strong organizational skills, particularly in maintaining accurate patient billing records and offering stellar customer service to patients and healthcare providers. Additionally, Cherry was a Provider Service Rep at Anthem Blue Cross Blue Shield GA, focused on supporting healthcare providers with claim inquiries and ensuring compliance. Cherry utilizes various EHR/EMR systems like Practice Suite and communications tools like Zoom to streamline operations efficiently.
Experience
Provider Service Rep
Anthem Blue Cross Blue Shield GA · 2017 — 2023Responded to inquiries from healthcare providers about patient claims, benefits, and payment statuses. Investigated and resolved issues related to claims processing and eligibility. Educated providers on relevant policies, procedures, and system updates. Maintained relationships with healthcare providers to enhance collaboration and operations. Ensured accuracy of provider information in internal systems. Monitored compliance with healthcare regulations and reported compliance requirements. Assisted with complex claims to help providers navigate the claims process.Sales and Customer Service Rep
Sykes Asia Inc · 2007 — 2017Handled customer inquiries via phone, email, or chat with professionalism. Assisted customers with concerns, ensuring prompt and accurate resolutions. Processed customer requests such as account updates and billing inquiries. Maintained accurate customer records by documenting interactions. Addressed complaints with empathy and aimed to improve customer experiences. Coordinated with internal teams to resolve complex issues. Provided detailed information about products or services to assist customers.CLAIM SPECIALIST, ACCOUNT RECEIVABLE, COLLECTIONS, INSURANCE ELIGIBILITY AND VERIFICATION, BILLING, PRECERT /PRE AUTH REP
CHERRY LCollected and verified patient demographic and insurance information. Followed up on claims to ensure timely processing and payment from healthcare providers. Resolved billing issues with both insurance companies and patients, addressing denials or rejected claims. Ensured all medical billing and coding practices complied with relevant regulations. Maintained accurate records of patient billing and insurance information. Provided customer service related to billing and insurance inquiries. Reviewed and analyzed denied claims to identify reasons for denial. Managed the appeals process for resubmitting claims or correcting errors. Verified patient eligibility and benefits prior to appointments to create accurate claims. Coordinated with providers and staff for coding clarification and authorization needs.