Elisabeth Edgerton
Goshen Health Care System
Mishawaka,IN
28
years of professional experience
Results-driven Revenue Cycle Specialist with proven success in claims processing and denial management. Strong analytical skills enhance revenue cycle performance and customer satisfaction.
Work History
Revenue Cycle Specialist
15 Years 9 Months- Implemented best practices in claims management, resulting in reduced denial rates.
- Collaborated with healthcare providers to ensure accurate patient billing and coding practices.
- Analyzed revenue cycle processes to identify inefficiencies and enhance overall performance.
- Trained staff on compliance standards and updated regulations impacting revenue cycle operations.
- Mentored junior team members, fostering a culture of continuous improvement and accountability.
- Trained new team members on revenue cycle best practices, contributing to a more knowledgeable workforce.
- Ensured accurate billing with thorough audits of patient accounts and insurance claims.
- Enhanced customer satisfaction by promptly addressing and resolving billing disputes.
- Reached out to insurance companies to verify coverage.
- Achieved optimal reimbursement rates by verifying insurance coverage, eligibility, benefits, and authorization prior to service delivery.
- Identified and resolved payment issues between patients and providers.
- Coordinated patient payment plans, balancing compassion with firmness to ensure timely payments while preserving positive patient relationships.
- Assisted patients in understanding complex billing statements, leading to increased trust between patients and healthcare providers.
- Balanced and reconciled accounts.
- Maximized reimbursements by staying current on payer requirements and maintaining strong relationships with insurance providers.
- Maintained clear documentation of all activities related to unpaid claims or denied services.
- Collaborated with cross-functional teams to improve overall financial performance of the organization.
- Improved cash flow with diligent follow-up on pending claims and appeals processes.
- Reduced outstanding account balances by implementing effective collection strategies.
- Improved patient satisfaction by providing clear, concise explanations of billing procedures and insurance coverage.
- Fostered culture of accountability within revenue cycle team, setting clear performance metrics and recognizing achievements.
- Enhanced revenue collection efficiency with robust follow-up procedures on delinquent accounts.
Registration Representative
11 Years- Coordinated with healthcare providers to verify insurance coverage and eligibility for patients effectively.
- Managed patient registration processes, ensuring accurate data entry and compliance with healthcare regulations.
- Utilized electronic health record systems to streamline patient information retrieval and enhance service delivery.
- Assisted patients in completing registration forms, providing clear instructions to facilitate smooth admissions.
Education
High School Diploma
Certified Professional Biller, CPB - Auditing
Skills
Claims processing proficiency
Claims processing
Medical billing expertise
Verifying insurance
Claims review
Document management
Accounts receivable management
Collecting payments
Customer service
HIPAA compliance
Payment collection
Customer service
Time management
Task prioritization
Multitasking
Excellent communication
Team collaboration
Active listening
Task prioritization
Professionalism and ethics
Timeline
Revenue Cycle Specialist
Goshen Health Care System
11.2010 - CurrentRead More
Registration Representative
Saint Joseph Regional Medical Center Inc
01.1999 - 01.2010Read More
Penn High School
High School Diploma
Read More
AAPC
Certified Professional Biller, CPB from Auditing
Read More