Amber Petty
St Louis,MO
Summary
I am looking for a position which will utilize my extensive knowledge of the Medical Industry, including but not limited to Excellent Patient Care, Comprehensive knowledge of Major Medical Billing/Reimbursement. Knowledgeable with proven history of optimizing revenue processes and enhancing financial performance. Successfully improved billing accuracy, streamlined collections, and contributed to increased profitability in previous roles. Exhibited analytical prowess and effective communication skills to resolve discrepancies and collaborate with cross-functional teams.
Overview
13
13
years of professional experience
Work History
Revenue Specialist II
DAVITA
04.2024 - Current
- Perform duties for revenue operations department related to setting patient insurance coverage
- Communicate with insurance payers to ensure proper insurance coverage for our patients or to ensure timely and accurate reimbursement for dialysis services rendered at our clinics
- Respond timely and accurately to payer communications
- Collaborate with other revenue operations teams to ensure seamless processes across teams
- Partner with clinics teammates such as Insurance counselors, social workers and facility administrators to ensure timely and accurate insurance information
- Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and DaVita policies
- Intake calls with insurance carriers regarding patient claims
- Uses critical thinking, problem-solving and analytical skills to determine the root cause and/or trends of our non-paid claims or underpayments from insurance payers and follow appropriate policy and procedure to remediate
- Uses exceptional organization, written, and verbal communication skills to produce detailed documentation of research and actions taken on claims
- Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and DaVita policies
- Answering inbound calls to provide information, including, account balance and insurance updates
- Use critical thinking, problem-solving and analytical skills to determine the root cause and/or trends of our non-paid claims or underpayments from insurance payers and follow appropriate policy and procedure to remediate
Senior Reimbursement Specialist
United Biosource Corporation
08.2022 - 03.2024
- Conduct benefit investigations, verify insurance benefits for patient and physicians’ offices, and submit and obtain prior authorizations as required by payer; obtain recertification for cases requiring extended treatment/coverage beyond the expiration of original approval.
- I was lead on the program for the whole time I was under this employer, I helped manage TM productivity, was SME for team, was the only member of the whole reimbursement team that would present results to customer – worked with National leader to have the most productive
Program Specialist II/Reimbursement Specialist
EVERSANA
02.2014 - 10.2021
- Submitting Prior Authorizations for patients both in home nursing infusions and/or outpatient infusions, supplies and medications. Daily pharmacy billing and reimbursement claims.
- Adjudicating claims for major medical and PBM, verifying benefits, also help patients obtain financial aid to help with insurance expenses.
- Discussing medical/pharmacy benefits and billing with patients to find the best option.
- Following up on insurance claims and issues that weren’t paid to get resolution.
- I was team LEAD for 7 Pilot programs- I oversaw 12-15 co-workers/Teammates
Territory Manager
Microdose Sales LLC
07.2012 - 01.2014
- Duties include: Managed Team from 5-10 Reps to guide them in establishing territory, meet sales quotas, keep accurate inventory, establish great relationships with Physician’s offices and staff, keep up to date on medical advances in all field related products, manage call logs, submit weekly call logs, submit relative field information to regional business manager, obtain signature logs, Submit spreadsheet on how to improve doctor/client base, ran weekly conference call, was in charge of team building in our region, took a territory that had never been worked and made it into one of the best producing territories, submit monthly inventory counts, submit and go over employee evaluations
Education
Bachelors of Science Degree - Liberal Studies, Communication, Psychology
University Of Missouri St. Louis
05.2012
Skills
- Microsoft Excel expertise
- Cash flow management
- Payment processing
- Salesforce proficiency
- Auditing procedures
- Collections management
- Interpersonal communication skills
- Account reconciliation
- Investigative techniques
- Detailed documentation
- Teamwork
- Customer service
- Teamwork and collaboration
- Problem-solving
- Time management
- Problem-solving aptitude
Qualifications
- -Over 9 years of Leadership Experience
- -Collects Reimbursements by coding, gathering, and transmitting patient info after making sure there are no discrepancies
- -Licensed Pharmacy Technician for 24 years
- -Strong Background in Insurance Reimbursement
- -Long Term Care Background Experience
- -Great Communication and Customer Relation Skills
- -Strong Specialty Pharmacy Background of 8 Years
- -24 Years of Reimbursement Experience
Timeline
Revenue Specialist II
DAVITA
04.2024 - Current
Senior Reimbursement Specialist
United Biosource Corporation
08.2022 - 03.2024
Program Specialist II/Reimbursement Specialist
EVERSANA
02.2014 - 10.2021
Territory Manager
Microdose Sales LLC
07.2012 - 01.2014
Bachelors of Science Degree - Liberal Studies, Communication, Psychology
University Of Missouri St. Louis