Oystern Talbert

Developed information specific documents to capture status, updates and payments for Medicaid, Medicare, Managed Care appeals and denials submissions and Workers' Compensation claims via EPIC EHR. Reviewed claim edit rejections, charge entry errors and denials for hospital and physicians billing for the Director of Revenue Cycle.

Adjudicated Medicare claims for all service types and provided auxiliary support for client services to resolve escalated phone inquiries. Communicated recurring claim edit issues and non-payment trends to the departmental manager.

Responsible for daily EPIC claim reports for urgent care centers and updated SharePoint for the organization's monthly online records. Submitted managed care, CMS, worker's compensation and disability claims electronically and by post with medical documentation as needed.

Created SOPs to generate claim reports in EPIC and eCW EMR systems for electronic and hard copy claims. Coordinated daily mail distribution to verify insurance payments, legal and court-related documents for C-suite officers and executives.

Twenty years of extensive experience in Epic HB/PB and modern EMR platforms, combining strategic prior authorization management and aggressive claims appeals to safeguard payment integrity, maintain PHI protocols and accomplish accurate claim resolutions.

Accomplished Senior Benefits Analyst with 25+ years of expertise in Employee Benefits Administration, Medical Billing, Claims Administration, Patient Financial Counseling and Benefits/Medical Insurance Compliance.