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Patricia Adams

@patriciaadams

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Denials Specialist at Conifer Health Solutions, resolving insurance claim denials with ACE and Epic.

United States

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What I'm looking for

I'm seeking a remote administrative, clerical, denials, appeals, or healthcare support role.

At Conifer Health Solutions, I resolve complex insurance claim denials using ACE and Epic. I investigate denial causes, coordinate with insurance carriers, and keep account documentation and Excel tracking reports accurate.

At Premier Choice Billing, I led appeals operations supporting 30 healthcare facilities. I developed appeal workflows and documentation procedures, researched regulations for out-of-network claims, and assisted with training initiatives.

At Athens Heart Center, I processed insurance claims and followed up on denials. I also verified eligibility, obtained pre-authorizations, and trained new employees across satellite offices.

Experience

Work history, roles, and key accomplishments

Current

Denials Specialist

Current

Conifer Health Solutions

Aug 2022 - Present (4 years 1 month)

Resolve complex insurance claim denials using ACE and Epic systems, investigate denial causes, and coordinate with insurance carriers for claim resolution. Maintain detailed account documentation and denial tracking reports in Excel while ensuring HIPAA compliance.

Ace Epic Excel Microsoft Teams Outlook Adobe HIPAA compliance Denial Management Insurance Claims Remote Collaboration

Lead Appeals Specialist

Premier Choice Billing

Nov 2018 - Jul 2022 (3 years 8 months)

Led appeals operations supporting 30 healthcare facilities, researched state and federal regulations, and developed appeal workflows and documentation procedures. Monitored project deadlines and assisted with employee evaluations and training.

Appeals Management Healthcare Regulations Workflow Development Project Management Corporate Trainer Insurance Communications Reimbursement

Insurance Billing Coordinator

Athens Heart Center

Dec 2002 - Oct 2018 (15 years 10 months)

Processed insurance claims, payment postings, and denial follow-up activities, verified insurance eligibility, and obtained pre-authorizations. Assisted patients with billing inquiries and trained new employees across satellite offices.

Insurance Billing Claims Processing Payment Posting Denial Balance Follow Up Insurance Verification Pre Authorization Patient Billing Training