Stacy Starr
@stacystarr
Senior healthcare claims and accounts resolution specialist focused on accurate reimbursements.
United StatesWhat I'm looking for
I’m a Senior Healthcare Claims and Accounts Resolution Specialist with 6+ years of experience in healthcare insurance, claims processing, appeals resolution, and reimbursement recovery.
I investigate denied and underpaid claims, resolve complex account discrepancies, and ensure compliance with payer guidelines and healthcare regulations. I’m recognized for strong analytical abilities, attention to detail, and consistently exceeding productivity and quality benchmarks in fast-paced, remote environments.
In recent roles, I’ve managed high-volume work queues, prepared and submitted detailed payer appeals with supporting documentation, and analyzed account activity and payment discrepancies to identify root causes. I also coordinate with attorneys, insurance carriers, providers, members, and clinical teams to obtain the information needed for compliant, timely determinations.
Experience
Work history, roles, and key accomplishments
Investigate and resolve complex denied and unpaid healthcare claims to support accurate reimbursement. Prepare payer appeals with supporting documentation, analyze account/payment discrepancies, and maintain audit-ready HIPAA and compliance standards.
Senior Claims Appeal Resolving Analyst
UnitedHealthcare
Feb 2023 - Oct 2023 (8 months)
Investigate provider and member appeals related to coverage, claims processing, and reimbursement. Conduct case analysis using policy guidelines and claim history, coordinate medical review as needed, and prepare compliant written appeal determinations within regulatory timelines.
Manage recovery cases to resolve complex reimbursement issues by posting payments, analyzing adjustments, and identifying causes of discrepancies. Communicate with attorneys, adjusters, and members while maintaining HIPAA/PHI compliance and supporting team onboarding.
Prepare and bill complex healthcare invoices aligned with payer guidelines and verify insurance coverage for accurate claims processing. Coordinate with examiners, adjusters, and attorneys to expedite claim resolution while maintaining HIPAA and regulatory compliance.
Deliver mail and packages along assigned routes with accuracy and efficiency. Maintain records for certified and registered mail and prepare and sort mail for daily distribution.
Education
Degrees, certifications, and relevant coursework
St. Florian High School
High School Diploma
Earned a High School Diploma from St. Florian High School in Hamtramck, Michigan.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Job categories
Skills
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