CHELSEY VAN DER LINDEN
NeoGenomics
CARLSBAD,CA
24
years of professional experience
Experienced Medical Billing and Revenue Cycle Specialist with 14 years in medical billing, insurance reimbursement, and accounts receivable. Expertise in Medicare, Medicaid, commercial insurance, and revenue cycle processes. Skilled in maximizing reimbursement, resolving complex billing issues, and improving workflows through effective collaboration with cross-functional teams.
Work History
Senior Billing Reimbursement Specialist
10 Years 7 Months- Managed the full revenue cycle for hospital, laboratory, Medicare, Medicaid, commercial insurance, managed care organizations, and third-party payer claims from submission through final reimbursement.
- Resolved unpaid, underpaid, and denied claims through comprehensive payer research, insurance portals, provider representatives, and internal systems to maximize reimbursement.
- Prepared and submitted first- and second-level appeals for medical necessity, prior authorization, timely filing, LCD/NCD diagnosis, coordination of benefits, out-of-network, duplicate claim, and non-covered service denials.
- Reviewed EOBs, ERAs, and payer correspondence to identify payment discrepancies, coding issues, and reimbursement opportunities.
- Collaborated with hospital revenue cycle teams, coding, laboratory operations, medical records, client services, and leadership to resolve complex billing issues and reduce recurring denials.
- Verified insurance eligibility, benefits, referrals, authorizations, and payer requirements to improve first-pass claim acceptance.
- Managed multiple high-volume work queues, including Aging, Timely Filing, Medical Records, Refunds, OnBase, Correspondence, and Special Projects while consistently exceeding productivity and quality goals.
- Processed credit balance reviews, overpayment recoveries, refunds, account adjustments, and payer recoupments in compliance with regulatory and company guidelines.
- Utilized multiple payer portals to verify benefits, obtain claim status, upload documentation, submit reconsiderations, and resolve reimbursement issues.
- Communicated with insurance representatives to clarify coverage policies, payment methodologies, contractual requirements, and appeal processes.
- Worked directly with patients to obtain required documentation, including Designation of Representation (DOR) forms, Claimant Statements, New York Surprise Billing documentation, and supporting records.
- Identified denial trends and workflow opportunities, contributing to reduced payment delays and improved reimbursement outcomes.
- Developed standardized appeal templates and reference materials that improved consistency, efficiency, and turnaround times.
- Maintained HIPAA compliance while safeguarding confidential patient and financial information.
- Served as a departmental resource by assisting teammates with complex accounts, payer-specific issues, and training support.
- Reviewed claims using National Correct Coding Initiative (NCCI) edits to identify bundling conflicts, verify appropriate modifier usage, determine when modifiers were missing or incorrectly applied, and ensure accurate claim submission, coding compliance, successful denial resolution, and maximum allowable reimbursement.
Medical Billing, Insurance Contracting, Accounts Receivable & Payable
2 Years 10 Months- Managed the full billing and reimbursement process for durable medical equipment (DME) and medical supply claims submitted to Medicare, Medicaid, Blue Cross Blue Shield, managed care organizations, and commercial insurance carriers.
- Verified patient eligibility, insurance benefits, referrals, prior authorizations, and coverage guidelines to ensure accurate claim submission and timely reimbursement.
- Submitted electronic and paper claims while monitoring claim status through payer portals, clearinghouses, and insurance websites.
- Investigated, corrected, and appealed denied, rejected, unpaid, and underpaid claims by reviewing medical documentation, payer policies, coding requirements, and contractual guidelines.
- Performed comprehensive insurance follow-up to resolve payment delays, reimbursement discrepancies, claim rejections, and requests for additional documentation while maintaining timely filing compliance.
- Managed accounts receivable by prioritizing aging accounts, reducing outstanding balances, and improving cash collections through proactive follow-up and account resolution.
- Negotiated reimbursement with insurance carriers, resolved payer disputes, and educated patients regarding insurance benefits, coverage limitations, and financial responsibility.
- Processed PPO exceptions, out-of-network authorizations, Letters of Agreement (LOAs), single-case agreements, and special reimbursement requests to facilitate appropriate claim payment.
- Coordinated referrals and prior authorizations with physicians, clinical staff, case managers, and medical directors to support timely patient care and reimbursement.
- Assisted with commercial and managed care contracting by maintaining payer agreements, updating provider participation records, reviewing reimbursement schedules and fee schedules, verifying contract terms, tracking contract renewals, and ensuring compliance with payer requirements and regulatory guidelines.
- Collaborated with payer representatives to resolve contract-related reimbursement issues, clarify policy provisions, and support implementation of contract updates affecting billing and reimbursement.
- Processed accounts payable, vendor invoices, purchase orders, payment reconciliations, and financial documentation while maintaining accurate accounting records.
- Partnered with cross-functional departments to resolve billing discrepancies, improve documentation accuracy, and streamline revenue cycle operations.
- Maintained strict HIPAA compliance while safeguarding confidential patient health information and financial records.
Customer Service & Sales Representative
5 Years 4 Months- Managed high-volume customer accounts while providing exceptional service and ensuring timely order processing.
- Consistently exceeded sales and customer satisfaction goals through relationship building, problem-solving, and effective communication.
- Processed customer orders received via telephone, email, fax, and electronic ordering systems with a high degree of accuracy.
- Resolved customer inquiries, order discrepancies, product issues, and service requests promptly while maintaining strong customer relationships.
- Coordinated order fulfillment and monitored shipments through FedEx, UPS, and other carriers to ensure on-time delivery.
- Processed customer credits, returns, and account adjustments while maintaining accurate customer records and documentation.
- Prepared reports, spreadsheets, business correspondence, and other administrative documents using Microsoft Office, including Excel, Word, and Outlook.
- Collaborated with sales, warehouse, and operations teams to resolve order issues, improve customer satisfaction, and support daily business operations.
Administrative, Sales & Accounting Assistant
3 Years 10 Months- Managed accounts payable, accounts receivable, collections, and vendor payments to ensure timely and accurate financial transactions.
- Processed invoices, customer payments, and credit card transactions, facilitating smooth cash flow management.
- Maintained petty cash and financial records, supporting accurate financial reporting and accountability.
- Assisted with sales, customer service, and business development.
- Managed order entry, shipping coordination, and vendor communications.
- Organized office records and administrative operations.
Education
- Coursework in:
- Microsoft Office
- Microsoft Excel
- Microsoft PowerPoint
- Adobe Applications
High School Diploma
Skills
Revenue Cycle Management (RCM)
Medical Billing & Insurance Claims Processing
Health insurance expertise
Appeals & Denial Management
Prior Authorization & Referral Coordination
Insurance Verification & Benefits Investigation
Accounts Receivable (AR) Management & Collections
Credit Balance Resolution & Refund Processing
Claims Follow-Up & Provider Portal Management
Timely Filing Compliance & Payment Resolution
HIPAA Compliance & Patient Data Privacy
Customer Service & Patient Relations
Microsoft Office Suite (Word
Excel
PowerPoint)
Data Entry (60 WPM) & 10-Key Proficiency
Process Improvement & Cross-Functional Team Collaboration
HIPAA compliance
Patient communication
Claims processing
Claim Reconsiderations
Timeline
Senior Billing Reimbursement Specialist
NeoGenomics
10.2015 - 05.2026Read More
Medical Billing, Insurance Contracting, Accounts Receivable & Payable
North Coast Medical Supply
01.2012 - 11.2014Read More
Customer Service & Sales Representative
Paul Ecke Ranch
09.2006 - 01.2012Read More
Administrative, Sales & Accounting Assistant
Tire Exchange
10.2002 - 08.2006Read More
Carlsbad High School
High School Diploma
Read More
MiraCosta College
Read More