Brittany Kohlmeyer
Kenosha,WI
Summary
Forward-thinking Billing & Claims Specialist bringing 6+ years of expertise in the healthcare insurance industry. Cultivates rapport with individuals to optimize team goals and output, resolve complex problems, identify trends and deliver a quality workload focused on detail. Always known for a positive attitude, reliability and strong work ethic.
Overview
9
9
years of professional experience
Work History
Claims Processing Representative, Home Health & Hospice
Advocate Aurora Health Systems
02.2022 - Current
- Responsible for daily electronic claims submissions to appropriate payer sources from 10 different work queues
- Responsible for timely processing and follow up of insurance claims with high variety of payers from 15+ work queues
- Focus specific follow-up on home health & hospice claims denied by insurance carriers or paid incorrectly to optimize reimbursement – working under/overpayments and refunds
- Confirming claim/account has been verified, billed, and paid correctly through payment analysis and adjustments – working denials and sending reconsiderations/appeals
- Possessing knowledge of all Home Health & Hospice payer contracts to accurately access underpayments and overpayments due to contract issues and be able to dispute/appeal
- Tracking medical records correspondence as it relates to claim processing
- Reporting trends with other departments that may improve claims submissions process such as coding issues or untimely charge application.
Denials Management Specialist
Cancer Treatment Centers of America
04.2021 - 02.2022
- Responsible for reimbursement and/or resolution of patient account balances while using follow-up tactics working accounts to exhaustion maximizing reimbursement
- Focus specific follow-up on hospital claims denied by insurance carriers or paid incorrectly to optimize reimbursement
- Confirming claim/account has been verified, billed, and paid correctly through payment analysis and adjustments
- Interacts and leverages, external and internal sources to overcome barriers, problem solve and resolve account balances
- Review and determine appropriate actions on assigned patient accounts a minimum of every 45 days for collection strategy/process
- Responsible for full denial assessment in work queue, including validation of denied charges, collaboration with site resources to ensure denials are appealed timely and payer follow-up regarding appealed accounts
- Identify and question any accounts/bills, problematic payers, payer trends, or unusual situations and bring to supervisor/director to mitigate issues.
Office Coordinator
Care Animal Hospital of Pleasant Prairie
11.2019 - 04.2021
- Maintain detailed administrative and procedural processes to improve patient accuracy and hospital efficiency including updating patient accounts/information daily
- Schedule appointments for patients while managing incoming and outgoing calls for high functioning large veterinary practice
- Give patient updates, discharge instructions, and provide follow up information for hospital patients
- Answer client inquiries, record messages for doctors and other staff
- Check patients in, discharge patients, dispense & maintain accuracy in medications & prescriptions, invoicing
- Post & record new client payments, running end of day transaction register
- Record patients' medical history, vital statistics, and test results in medical records
- Participate and strategize in team setting ways to increase hospital efficiency and patient flow to implement changes to increase monthly revenue.
Centralized Acct Reconciliation Specialist
Cancer Treatment Centers of America
05.2015 - 08.2018
- Provides reconciliation & resolution to all hospital accounts; sole stakeholder who makes all necessary adjustments
- Researching account adjustments by performing review of all applicable EOB’s, review of payments, review of contractual agreements & patient specific agreements
- Possesses extensive knowledge of each site’s financial policies medical/insurance terminology and adjustment codes
- Maintains accurate patient demographics and insurance information with routine updates of comments in each account worked
- Assisted with leading insurance offset project to streamline updated process with higher efficacy to catch errors and bring in anticipated revenue
Education
Bachelor of Science - Environmental Science
University of Phoenix
Phoenix, AZ07.2022
Skills
- Versed in Epic hospital systems
- Versed in Microsoft Excel & One Note
- Exemplary customer service in various settings
- Knowledge of insurance and medical terminology
- Data entry proficiency
- Stakeholder Collaboration
- Process Improvement
- Goal-oriented mindset
- Revenue Generation
References
References available upon request
Timeline
Claims Processing Representative, Home Health & Hospice
Advocate Aurora Health Systems
02.2022 - Current
Denials Management Specialist
Cancer Treatment Centers of America
04.2021 - 02.2022
Office Coordinator
Care Animal Hospital of Pleasant Prairie
11.2019 - 04.2021
Centralized Acct Reconciliation Specialist
Cancer Treatment Centers of America
05.2015 - 08.2018
Bachelor of Science - Environmental Science
University of Phoenix
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