Carlin Walker
Jackson
Summary
Dynamic Senior Customer Quality Specialist at Accendra Health Inc, skilled in training and coaching, with a strong background in medical billing and compliance. Enhanced customer satisfaction through effective collaboration and streamlined processes, ensuring accurate documentation and patient eligibility verification. Proven ability to resolve claims issues and improve operational efficiency.
Overview
17
17
years of professional experience
Work History
Senior Customer Quality Specialist
Accendra Health Inc
10900 Nuckols Rd, Glen Allen VA
07.2012 - 02.2026
- Developed and maintained documentation for quality assurance processes.
- Collaborated with cross-functional teams to enhance customer satisfaction initiatives.
- Processed incoming orders from physicians, hospitals, and patients, ensuring accurate data entry into DME software
- Determined patient eligibility, verify insurance benefits, and understand reimbursement criteria.
- Maintained accurate records, documenting all patient interactions, and adhering to HIPAA and company policies.
- Communicated financial responsibilities to patients, including co-pays and deductibles, and process payments.
Customer Inquiry Representative
Apria Healthcare
Jackson, TN
01.2009 - 07.2012
- Streamlined administrative workflows to enhance operational efficiency within the team.
- Trained new staff on company policies, procedures, and software systems.
- Reviewed patient records to verify required documentation (e.g., prescriptions, Certificates of Medical Necessity) and submitting "clean" claims using CMS-1500 forms.
- Confirmed patient insurance eligibility and obtaining necessary prior authorizations before equipment is dispensed.
- Researched why claims were rejected or denied and initiating corrective actions, such as resubmissions or formal appeals.
- Monitored unpaid claims, posting payments from insurance EOBs (Explanation of Benefits), and reconciling account discrepancies.
- Directly assisted patients with questions about their bills, payment plans, and insurance coverage.
Education
Bachelor of Science - Business Administration
Lane College
Jackson, TN04-2015
Skills
- Training and coaching
- Complaint handling
- Sales support
- CRM software expertise
- Safety & Compliance (HIPAA, Medicare, Medicaid Non-Gov insurance)
- Medical Terminology
- Proficiency in Electronic Health Records (EHR)
- Medical Billing
Timeline
Senior Customer Quality Specialist
Accendra Health Inc
07.2012 - 02.2026
Customer Inquiry Representative
Apria Healthcare
01.2009 - 07.2012
Bachelor of Science - Business Administration
Lane College