Looking for a job

Akilia Pemberton

@akiliapemberton

Healthcare data analyst at Amdari who improved SQL retrieval efficiency by 40% across clinical datasets.

At Amdari, I improved SQL data-retrieval efficiency by 40% across clinical datasets. I also cleaned and validated healthcare records and built Power BI and Tableau dashboards tracking wait times, readmissions, bed occupancy, and population health.

At Mains'l Services, I review 837 claims and 835 remittance files, investigate denials and underpayments, and reconcile billed services with the General Ledger. I also work with vendors to troubleshoot billing-system and EDI issues.

Across roles at Allina Health, Ucare, Fairview Health Services, and other healthcare organizations, I’ve worked with claims, reimbursement, coding, eligibility, and appeals. My projects include claims accuracy reporting and revenue reconciliation, using tools such as SQL, Microsoft Fabric, Excel, and healthcare billing systems.

Experience

Work history, roles, and key accomplishments

Current

Health Data Analyst

Current

Amdari

Jun 2026 - Present (4 months)

Improved SQL data-retrieval efficiency by 40% through query design and optimization. Cleaned and validated 50,000+ healthcare records, reducing data inconsistencies by 30%, and developed predictive models for patient no-shows with 85% accuracy.

SQL Power BI Tableau Excel Microsoft Fabric Data Cleaning Data Validation Predictive Analytics Healthcare Data Analysis Dashboard Development

Current

Remote Revenue Cycle Specialist

Current

Mains'l Services

Jan 2024 - Present (2 years 9 months)

Reviewed billing reports and analyzed 835 ERA files to match payments and identify discrepancies. Reconciled General Ledger and coordinated billing issue resolution with stakeholders and vendors.

Revenue Cycle Management Claims Analysis EDI 837 835 General Ledger Reconciliation Eligibility Verification Denials Management Root Cause Analysis

Remote Financial Clearance Representative

Allina Health

Jan 2023 - Dec 2024 (1 year 11 months)

Reviewed medical bills for accuracy and completeness using coding guidance and payer-specific requirements. Collaborated with coding specialists and clinicians to support accurate claim preparation.

Medical Billing Coding Charge Reviews Payer Requirements Claims Preparation Reporting

Remote RCM Insurance Representative

Allina Health / Adapt Health

Jan 2017 - Dec 2022 (5 years 11 months)

Analyzed claim rejections and denials to identify trends and guide corrective follow-up. Pursued unpaid balances through eligibility verification and appeal follow-up.

Claims Analysis Denials Management Eligibility Verification Appeals Revenue Cycle Management Documentation

Remote Insurance Representative

Professional Service Bureau

Jan 2016 - Dec 2017 (1 year 11 months)

Examined patient bills and payer responses to identify missing information and determine follow-up. Reviewed EOBs and denials to coordinate secondary billing, appeals, and follow-up.

Claims Review EOB Analysis Denials Management Payer Engagement Documentation

Remote Claims Examiner Senior

Ucare

Jan 2011 - Dec 2016 (5 years 11 months)

Investigated and adjusted paper and electronic claims, validating reimbursement using DRG and APC methodologies. Applied CMS and DHS requirements and reviewed internal audits to identify payment trends.

Claims Examination DRG APC CMS DHS ICD 9 ICD 10 CPT HCPCS Reimbursement Audit

Business Office Assistant

Redeemer Health & Rehab

Jan 2008 - Dec 2011 (3 years 11 months)

Maintained resident billing information and processed long-term-care billing for Medicaid and HMO payers. Posted and reconciled remittances, denials, and contractual adjustments.

Medical Billing Medicaid HMO MN ITS EPremis Reconciliations Resident Trust DHS County Eligibility

Medical Biller

Fairview Health Services

Jan 2006 - Dec 2008 (2 years 11 months)

Investigated payer rejections and denials for inpatient and outpatient services. Reviewed EOBs and remittance advice, assigned adjustment codes, and prepared appeals.

Medical Billing Denials Management EOB Analysis ICD 9 CPT 4 Coding Appeals Payer Guidelines

Reimbursement Specialist

Reliable Medical Supply

Jan 2003 - Dec 2006 (3 years 11 months)

Prepared durable medical equipment claims through charge entry and insurance verification. Used aging and denial reports to prioritize follow-up and prepared billing and month-end reports.

DME Billing Charge Entry Insurance Verification Denial Management Reporting Reconciliations