Dynamic Medicare Claims Specialist at Accenture with a proven ability to enhance claim approval rates through meticulous reviews and compliance management. Expertise in healthcare software systems and patient care, combined with strong multitasking and communication skills, ensures efficient workflows and superior service delivery in fast-paced environments.
Overview
13
13
years of professional experience
Work History
Medicare Claims Specialist
Accenture
Louisville
04.2025 - 09.2025
Managed the intake and processing of Medicare claims, ensuring compliance with regulations and timely submission.
Conducted thorough second submissions reviews to identify and resolve discrepancies, enhancing claim approval rates.
Utilized healthcare software systems to track claim status and streamline workflows.
Surgery Scheduler
UOSC
Knoxville
04.2024 - 02.2025
Handled all scheduling for patients, including pre-op and postop appointments, verified insurance, acquired surgery authorizations and clearances.
Radiology File Room
University of Tennessee Hospital
Knoxville
12.2020 - 04.2024
Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards.
Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
Offered simple, clear explanations to help clients and families understand hospital policies and procedures.
Followed document protocols to safeguard confidentiality of patient records.
Facilitated communication between patients and various departments and staff.
Applied administrative knowledge and courtesy to explain procedures and services to patients.
Organized patient records and database to facilitate information storage and retrieval.
Answer and direct calls on multi-line phone.
Meet multiple deadlines specific to the department.
CVICU Technician
University of Tennessee Hospital
Knoxville
11.2016 - 12.2020
Responded to patient emergencies with immediate care and notified clinicians to provide comprehensive assistance.
Assisted nursing staff with respiratory, cardiopulmonary, and physical therapies.
Supported patient admissions, discharges, and transfers to promote team productivity.
Collected and transported specimens to prepare for lab testing.
Monitored, tracked, and conveyed important patient information to healthcare staff and remained adaptable to help optimize treatment planning and care delivery.
Evaluated patients to identify and address wounds, behavioral concerns, and medically relevant symptoms.
CNA/Rehab Nursing Technician- Cardiac Stepdown Unit
Tennova Physicians Regional Medical Center
Knoxville
12.2012 - 11.2016
Delivered individualized patient care by recording vital signs, documenting observations, administering treatments, and evaluating patient needs.
Evaluated patients to identify and address wounds, behavioral concerns, and medically relevant symptoms.
Assisted with feeding and monitoring intake to help patients achieve nutritional objectives.
Supported ambulation and physical therapy needs by conducting planned exercise routines.
Obtained biological specimens for ordered tests and prepared for laboratory transport.
Facilitated personal hygiene management, feeding and ambulation.
Monitored patient specimen samples and test results to effectively alert supervisors of potentially unhealthy changes.
Maintained patient stability by checking vital signs, weight and recording outtake information.
Education
Civil Engineering
University of Tennessee
05.1998
Pre-Engineering
Pellissippi State Community College
05.1997
Skills
Medical imaging
Scheduling
Multiline phone management
Patient care
Communication skills
Supervising experience
Documentation
Meticulous attention to specifics
AMBRA
PACS
RadWorks
Cerner
Fuji
Windows
Information verification
Secure data practices
Computer proficiency
Multitasking Abilities
Task prioritization
Time management abilities
Database management
Records management
Appointment scheduling
Insurance software
Insurance claim forms review
Initiative-taking
Self motivation
Multi-tasking
Powershare
Next Gen
IQ
QNXT
Facets
OneView
OnBase
Knowledge
Affiliations
I enjoy experimenting with recipes and preparing meals with fresh ingredients.
I value spending quality time with my family which usually involves watching sports and food.
I love music and appreciate a lot of genres.
Accomplishments
My fifteen minutes of fame was winning the Chocolate Fest in 2001.
References
References available upon request.
Timeline
Medicare Claims Specialist
Accenture
04.2025 - 09.2025
Surgery Scheduler
UOSC
04.2024 - 02.2025
Radiology File Room
University of Tennessee Hospital
12.2020 - 04.2024
CVICU Technician
University of Tennessee Hospital
11.2016 - 12.2020
CNA/Rehab Nursing Technician- Cardiac Stepdown Unit