Colleen Thelen
Merrillville,IN
Summary
Dedicated, well organized AR/MCO Revenue Cycle Coordinator accustomed to functioning in a fast-paced environment with over 14 years plus in the healthcare Industry. Can perform a variety of complex billing and accounting functions, for patient billing including verification of invoice information, maintenance of third-party billing and resolution of a variety of problems. AR Follow up on submitted claims and patient billing, resubmit claims and resolve problems. Handles cash items and accounts receivable posting. Excellent interpersonal skills with the ability to research, plan and negotiate, analyze and be an excellent contribution to a productive team resulting in the highest level of service.
Overview
16
16
years of professional experience
Work History
AR/MCO/IDOA Coordinator Revenue Cycle
Help at Home
09.2020 - 12.2024
- Respond to phone calls, voice mails, and emails
- Complete billing for Revenue Day and ensure billed claim is received by the payer
- Complete Rejections in the Waystar Portal
- Complete Denials in the Waystar portal
- Review all claims that the authorization team retrieved authorizations for or all the claims that an authorization check was completed for
- Review all resubmitted claims to ensure they are being
- Follow up on missing authorizations in the 180 (or review that it has been requested by MCO auth team)
- Follow up on outstanding eligibility issues in the 180 (or review that it has been requested by the Eligibility team)
- Status all claims in the 180
- Timely filing claims must be appealed or written off
- Exceeding authorizations needed to be reviewed and disputed if necessary
- Follow up with provider representative on any outstanding issues
- Provide accurate monthly status summaries on assigned payers
- Communicate with insurance companies, providers and prescribers to coordinate reimbursement and access solutions
- Reviews unpaid accounts to determine status and take appropriate action to ensure payment
- Reviews all claims for compliance and completeness for claims submissions
- Always maintains a high degree of confidentiality due to access to sensitive information
- Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department
- Follows all Medicare, Medicaid, and HIPAA regulations and requirements
- Abides by all regulations, policies, procedures and standards
- Performs other duties as assigned
- Managed project timelines for successful completion, ensuring milestones were met and deadlines were adhered to.
- Enhanced customer satisfaction by responding promptly to inquiries and addressing concerns professionally.
- Gathered and organized materials to support operations.
- Enhanced operational workflows by maintaining well-organized documentation systems and updating records accurately as needed.
- Improved team productivity with regular communication and progress updates, fostering a collaborative work environment.
- Entered data, generated reports, and produced tracking documents.
- Coordinated cross-functional teams, resulting in seamless project execution and enhanced outcomes.
- Resolved issues through active listening and open-ended questioning, escalating major problems to manager.
- Kept high average of performance evaluations.
Revenue Cycle Biller & Collector
Addus Home Care
07.2017 - 07.2020
- Coordinate and facilitate all aspects of the timely billing for a defined set of locations and payers and clients
- Work with assigned branches to obtain necessary documentation to process billing in accordance with payer and/or company guidelines
- Submit electronic and manual claims adhering to strict deadlines
- Manage unbilled reports to ensure all billing for assigned areas are processed
- File supplemental billing for any late entries within payer filing limits
- Provide billing guidance and support to the branch locations
- Review accounts receivable reports regularly for any problematic accounts/payers, trends and ensures timely follow up
- Work with payers and branches to reach resolution on any unpaid claims
- Complete write offs/adjustments for non-collectable AR and routes as appropriate timely for approval
- Maintain optimal communication and rapport with payers and branches
- Offer input and maintaining reporting requirements relative to assigned accounts
- Identify and notify supervisor of changes in payer guidelines
- Training necessary, Cash app, credit, deposit and refund applications
- Appeals/Settlements/Audits
- Team Leads Back-Up
- Bill and collect on Long Term Care Insurance, Workman’s Comp, all MCO, Medicaid
- Work with collection agencies, probate agencies, attorney’s
- Verified accuracy of accounts payable payments, resulting in 85% reduction in payment errors and check reissues.
Insurance Follow Up/ Medical Billing Specialist
Rev Md Partners
10.2014 - 06.2017
- Provided customer service to various health care contract customers
- Prepared, researched invoices and collected from various contracted health insurance payers
- Read through health care contracts and contract language to ensure proper contract workflows
- Researched remits and EOBs for complete accurate payments or denials
- Provided or arranged for additional information when needed
- Billed and or submitted corrected claims and/or appeals
- Requested and submitted appropriate adjustments, when required
- Ensured legal compliance by following company policies and guidelines, as well as state and federal insurance regulations
- Worked excel spreadsheets to audit outstanding accounts
- Systems used, Ixfin, Rev Manager, Rev Cycle, and Availity
- Verified accuracy of accounts payable payments, resulting in 85% reduction in payment errors and check reissues.
- Verified accuracy of accounts payable payments, resulting in 85% reduction in payment errors and check reissues.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Located errors and promptly refiled rejected claims.
Management/Property Management Asst/Accounts Receivable/Payable
JFC LLC
04.2009 - 09.2014
- Maintained records regarding the property; including all income expenses; list of all inspections signed leases
- Maintenance requests, tenant complaints; records of repairs; costs of repairs; maintenance costs; record of rent collection and insurance costs
- Found tenants, screened tenants and assisted in handling all aspects of the leases
- Prepared monthly service reports
- Organized tenant meetings
- Prepared and analyzed monthly performance reports, including accounting reconciliation
- Supervised service desk, handling more than 1500 calls per month
- Self-motivated, with a strong sense of personal responsibility.
- Worked effectively in fast-paced environments.
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
- Excellent communication skills, both verbal and written.
- Worked well in a team setting, providing support and guidance.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Passionate about learning and committed to continual improvement.
- Managed time efficiently in order to complete all tasks within deadlines.
- Paid attention to detail while completing assignments.
- Organized and detail-oriented with a strong work ethic.
- Strengthened communication skills through regular interactions with others.
- Developed and maintained courteous and effective working relationships.
Education
Diploma -
Reavis High School
Burbank, IllinoisCertification - Cosmetology
Tricochi University of Beauty Culture
Bridgeview, Illinois01.2011
Major - Medical Coding
Moraine Valley Community College
Palos Hills, Illinois01.2010
Major - Criminal Justice
Moraine Valley Community College
Palos Hills, Illinois01.1998
Skills
- Multitasking and organization
- Customer service
- Data entry
- Decision-making
- MS office
- Relationship building
- Work Planning and Prioritization
- Schedule coordination
- Document management
- Presenting ideas and plans
- Project Support
- Medical terminology
- Insurance verification
- Accounts reconciliation
- Problem-solving
- Time management
- Attention to detail
- Clear communication
- Verbal and written communication
- Conflict resolution
- Medical billing
- Team leadership
- Phone and email etiquette
- Customer service management
- Appointment scheduling
- Goal setting
Additional Information
Articulate and persuasive when communicating with internal and external. Expertise in many different fields, with excellent abilities in client problem resolution. Highly motivated leader, driven, reliable, self-starter, able to quickly understand applications and processes. Extensive experience with service management, applications and processes. Highly goal oriented, fast learning, professional, dependable, flexible, dedicated, excellent team player, problem solver and trouble shooter. Excellent communication skills.
Languages
English
Timeline
AR/MCO/IDOA Coordinator Revenue Cycle
Help at Home
09.2020 - 12.2024
Revenue Cycle Biller & Collector
Addus Home Care
07.2017 - 07.2020
Insurance Follow Up/ Medical Billing Specialist
Rev Md Partners
10.2014 - 06.2017
Management/Property Management Asst/Accounts Receivable/Payable
JFC LLC
04.2009 - 09.2014
Certification - Cosmetology
Tricochi University of Beauty Culture
Major - Medical Coding
Moraine Valley Community College
Major - Criminal Justice
Moraine Valley Community College
Diploma -
Reavis High School
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