Annjilla Walker
@annjillawalker
Detail-oriented medical provider service associate with extensive claims experience.
What I'm looking for
I am an exceptional Medical Provider Service Associate with over a decade of experience in customer and provider service roles within the healthcare industry. My career has been marked by a commitment to detail, analytical problem-solving, and a fast-learning approach that has allowed me to excel in various positions, including claims specialist and revenue recovery specialist.
At Park Nicollet Methodist Hospital, I investigate and resolve complex issues related to claims, payments, and referrals, ensuring compliance with insurance guidelines. My role involves facilitating claim re-submissions and obtaining necessary information to overturn denials, which has significantly improved our claims processing efficiency. Previously, at Knowtion Health, I honed my skills in analyzing denied claims and coordinating with various departments to maximize revenue recovery.
My educational background in Billing and Coding complements my practical experience, equipping me with a solid understanding of medical terminology and insurance processes. I am passionate about delivering exceptional service and continuously seek opportunities to enhance my skills and contribute to my team's success.
Experience
Work history, roles, and key accomplishments
Claims Specialist
Park Nicollet Methodist Hospital
May 2024 - Present (1 year 2 months)
Investigated and resolved issues with claims, payments, referrals, and precertifications. Prioritized and resolved specialty accounts including balances on MVA, Mental/Behavioral health, Medicare, Medicaid, Correctional facility, Grant programs, and Miscellaneous payer claims.
Revenue Recovery Specialist
Knowtion Health
Apr 2019 - May 2024 (5 years 1 month)
Analyzed information to identify the root cause of denied or unpaid claims and investigated and solved problems with claims, payments, referrals, and precertification. Composed and followed up on claims appeals, ensuring appropriate timely filing guidelines were met for maximum reimbursement.
Transportation Service Coordinator
Airport Taxi
Sep 2017 - Jan 2018 (4 months)
Coordinated medical rides with major medical carriers and scheduled transportation with charities, non-profit entities, homeless, and abuse shelters. Managed multi-line phone systems and operated multiple computer programs simultaneously and efficiently.
Provider Service Coordinator
Medica
Jun 2016 - Jan 2017 (7 months)
Applied organizational guidelines to make claims adjudication decisions and routed claims to other departments for review as appropriate. Provided information to providers concerning the status of member's coverage, benefits, referral status, and claim status.
Education
Degrees, certifications, and relevant coursework
High Tech Institute
Associate, Billing and Coding
Completed an Associate degree in Billing and Coding. Gained expertise in medical claims, billing, insurance, and administrative support within the healthcare industry.
Tech stack
Software and tools used professionally
Availability
Location
Authorized to work in
Job categories
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