Chelsea Bolton
Florence,KY
Summary
Experienced data analyst specializing in the medical revenue integrity field with a proven track record of over a decade. Known for adaptability and reliability, while maintaining a results-driven approach to tasks. Seeking a new and challenging opportunity to drive success for a forward-thinking organization.
Overview
10
10
years of professional experience
Work History
R&D Data Analyst
Revecore
Crescent Springs, KY
01.2025 - Current
- Analyzes data to identify root causes of problems with company AI systems and recommend to leadership and data scientists corrective actions.
- Improves decision-making processes with accurate data analysis and visualization techniques.
- Optimizes data collection methods to enhance quality and volume of data captured for analysis
- Collaborates with cross-functional teams to ensure data integrity and accuracy, resulting in better-informed decisions.
- Created various Excel documents to assist with pulling metrics data and presenting information to stakeholders for concise explanations.
Hospital Claims Analyst
Revecore
Crescent Springs, KY
08.2019 - 12.2024
- Reviewed hospital claims and researched if services have been paid according to the contract and/or applicable state and federal regulations.
- Effective in identifying underpayments for issues including, but not limited to ICD-10, CPT/HCPCS coding denials, and payer processing errors resulting in over $2.5 million in collections.
- Experienced in interpreting Managed Care and Qualified Health Plan contracts and pricing services utilizing different payment methodologies, such as MS-DRG, APR-DRG, case rates, fee schedules, EAPG, and APCs.
- Communicated with insurance companies via written correspondence and telephone regarding claim/appeal status, and for investigational purposes.
- Proficient in EPIC, Meditech, FinThrive, Rev Cycle Pro, and Change Healthcare.
- Reported findings, trends, and any issues to leadership. Additionally responsible for maintaining detailed end of month reports.
Sleep Intake Supervisor
Patient Home Monitoring
Wilder, KY
09.2015 - 08.2019
- Oversaw department to ensure prescriptions for PAP devices, and other respiratory related machines are processed accurately and timely by Medicare, several state Medicaid plans, and commercial insurances.
- Balanced orders, referral and patient communications between 6 PHM sister companies spanning across the Eastern US.
- Verified appropriate medical records were received from referral sources confirming that patients qualify. Including, but not limited to analyzing sleep studies, pulse oximeters, six minute walk tests, etc.
- Trained new employees in policies and procedures, assigned regions, and insurances they will be responsible for. Additionally, provided updates and constructive criticisms to management on all team members.
- Established rapport and acted as a liaison between all referral sources and PHM branches, while simultaneously providing superb customer service to our patients.
Education
Biology
University of Cincinnati
Cincinnati, OHSkills
- Task Prioritization
- Active Listening
- Client Contact
- Training and Development
- Project Management
- Microsoft Office
- Workflow Optimization
- Research and Analysis
- Promoting Teamwork
- Complex Problem-Solving
- Adaptation to Technology
- Active Learning
Timeline
R&D Data Analyst
Revecore
01.2025 - Current
Hospital Claims Analyst
Revecore
08.2019 - 12.2024
Sleep Intake Supervisor
Patient Home Monitoring
09.2015 - 08.2019
Biology
University of Cincinnati