Proficient revenue cycle specialist experienced in claims processing and denial management. Demonstrated ability to implement process improvements, enhance accuracy, and resolve billing discrepancies, resulting in increased revenue and improved customer satisfaction.
Overview
38
38
years of professional experience
Work History
Revenue Cycle Specialist
Compassus Hospice
Brentwood, TN
09.2024 - 03.2026
Processed patient billing and insurance claims with accuracy and attention to detail.
Collaborated with clinical teams to ensure seamless revenue cycle operations.
Analyzed discrepancies in billing and resolved issues promptly to enhance revenue flow.
Maintained updated knowledge of hospice regulations and reimbursement policies to ensure compliance.
Implemented process improvements that streamlined billing workflows and reduced claim denials.
Increased revenue by identifying and resolving billing errors in a timely manner.
Enhanced customer satisfaction by promptly addressing and resolving billing disputes.
Ensured accurate billing with thorough audits of patient accounts and insurance claims.
Provided regular updates on billing status to upper management through detailed reports.
Maximized reimbursements by staying current on payer requirements and maintaining strong relationships with insurance providers.
Balanced and reconciled accounts.
Maintained clear documentation of all activities related to unpaid claims or denied services.
Improved cash flow with diligent follow-up on pending claims and appeals processes.
Reduced outstanding account balances by implementing effective collection strategies.
Optimized revenue cycle, implementing effective strategies for claims management and reimbursement.
Reduced turnaround time for claim submissions, ensuring compliance with healthcare regulations through diligent documentation.
Developed and maintained up-to-date knowledge of coding standards, contributing to fewer coding errors and denials.
Participated in client meetings to discuss financial analysis and investment strategies.
Billing Specialist
Mercy Health - Hospice, Lima
Lima, OH
11.2000 - 09.2024
Processed and reviewed patient billing statements for accuracy and completeness.
Coordinated with insurance providers to resolve billing discrepancies.
Implemented best practices for timely claims submission and follow-up.
Conducted audits to ensure compliance with regulatory standards and policies.
Developed streamlined workflows that improved efficiency in billing operations.
Analyzed billing data to identify trends and optimize revenue cycle management.
Processed medical claims accurately and efficiently using electronic billing systems.
Reviewed patient accounts for discrepancies, ensuring resolution of billing issues.
Collaborated with healthcare providers to verify insurance eligibility and coverage details.
Implemented coding compliance protocols, reducing claim denials and improving accuracy.
Communicated with insurance providers to resolve denied claims and resubmitted.
Posted and adjusted payments from insurance companies.
Identified and resolved patient billing and payment issues.
Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
Maintained strong working relationships with healthcare providers, fostering clear communication regarding billing-related matters.
Managed patient accounts effectively, resolving discrepancies and addressing outstanding balances in a timely manner.
Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
Collected payments and applied to patient accounts.
Precisely completed appropriate claims paperwork, documentation and system entry.
Precisely evaluated and verified benefits and eligibility.
Streamlined billing processes by implementing efficient workflows and utilizing advanced software tools.
Efficiently processed refunds or adjustments for patients when necessary, ensuring accuracy and compliance with company policies.
Prepared billing correspondence and maintained database to organize billing information.
Monitored changes in payer requirements, adjusting billing practices accordingly to minimize disruptions in the revenue cycle.
Conducted regular audits of patient accounts for potential underpayments or overpayments due to incorrect coding or billing practices.
Participated in departmental meetings, sharing insights and ideas for improving overall medical billing efficiency and revenue generation.
Collaborated with team members to address customer needs effectively.
Provided support during peak hours, improving service efficiency and responsiveness.
Maintained clean and organized entrance area to promote positive first impressions.
Maintained a clean and organized entrance area, contributing to a positive first impression for visitors.
Answered customer questions and pointed individuals in right directions.
Provided friendly, attentive service throughout peak times for responsive customer care.
Assisted patrons with inquiries and directed them to appropriate departments for further assistance.
Helped create an enjoyable environment for customers by engaging in friendly conversation while they waited in line.
Accounting Clerk
Time Warner Cable
Lima, OH
08.1991 - 11.2000
I did varies of jobs at Time Warner Cable - accounts receivable for payment processing when customers paid their cable bills, helped with varies of jobs for VP of Engineering, helped Accounts Payables with the invoices needed to be paid / mailing them out / filing the copies of the invoices and checks.
Kitchen Prep Cook
Bob Evans Restaurant
Lima, OH
03.1988 - 10.1991
Prepared ingredients following standardized recipes and portion guidelines.
Maintained cleanliness and organization of kitchen workstations and equipment.
Assisted in food preparation tasks, ensuring timely service during peak hours.
Collaborated with team members to enhance workflow efficiency in kitchen operations.
Set up and prepared cooking supplies and workstations during opening and closing to maximize productivity.
Washed, peeled, and cut fruits and vegetables in advance to save time on food preparation.
Preserved freshness of food by storing food in designated containers and storage areas within freezer or refrigerator.
Handled high-volume prep work efficiently, ensuring all ingredients were prepared accurately and promptly.
Maintained clean, hygienic kitchen workspace by sweeping, mopping, and taking out trash.
Reduced food waste by effectively managing ingredient inventory and rotating products as needed.
I started off as a busser - cleaning the tables, bringing in the bins of dirty dishes to the back to be washed, sometimes helped out the dishwasher (a person) by putting away the clean dishes, pots and pans, cleaned the restrooms during business hours and at closing time.
Education
Associate Degree in Accounting With Using Computer -
Lima Technical College
Lima, OH
03-1991
No Degree -
Lima Central Catholic High School
Lima, OH
05-1987
Skills
Claims review
Claims processing proficiency
HIPAA compliance
Professionalism and ethics
Insurance verification
Payment posting
Month-end closing procedures
Denial management
Billing systems and software
Invoice processing
Claims processing
Audit procedures
Timeline
Revenue Cycle Specialist
Compassus Hospice
09.2024 - 03.2026
Greeter
Meijer
10.2013 - 10.2015
Billing Specialist
Mercy Health - Hospice, Lima
11.2000 - 09.2024
Accounting Clerk
Time Warner Cable
08.1991 - 11.2000
Kitchen Prep Cook
Bob Evans Restaurant
03.1988 - 10.1991
Associate Degree in Accounting With Using Computer -