Heather Blocker
House Springs,Missouri
Summary
Senior Billing Analyst with 10+ years of healthcare revenue cycle experience. Supports hospital and physician billing across commercial, Medicaid, managed Medicaid, Medicare Advantage, and workers' compensation payers, working primarily with up-front payer rejections, coordination across teams, and Epic workflow support, while maintaining HIPAA-compliant billing processes.
Overview
18
18
years of professional experience
6
6
years of post-secondary education
1
1
Certification
Work History
Billing Analyst I
Mercy
01.2022 - Current
- Analyze and resolve a high volume of up-front payer rejections for hospital and physician claims, determining whether issues require claim-level updates, eligibility verification through payer portals, or routing to other departments such as coding
- Review complex claim issues that require additional analysis, evaluating claim data and payer requirements to determine the most appropriate correction or next step
- Prepare weekly and monthly up-front payer rejection reports for hospital and physician claims to support front-end review and trend identification
- Review rejection patterns to identify systemic resolution opportunities and escalate issues through Epic Gatekeeper tickets or SSI revenue requests when appropriate
- Serve as a Claims Gatekeeper and liaison between end users and Epic analysts, reviewing and prioritizing ticket submissions, determining when Epic escalation is appropriate, and coordinating testing, validation, and post-implementation support for approved system changes
- Serve as Co-Lead for the paper billing team (since November 2024), providing leadership support, workflow guidance, issue escalation, and audit oversight
- Lead efforts to expand workers' compensation plans from paper to electronic submission using Jopari through SSI clearinghouse, including refinement of medical records selected for electronic attachments
- Acted as the primary resource for Oklahoma Medicaid claim processing following COVID-related changes that eliminated paper submissions, handling medical record saving, faxing, and electronic uploads via the OHCA portal during both Billing Representative and Billing Analyst roles.
- Created and updated detailed step-by-step workflow documentation as needs were identified to support billing workflows
Billing Representative III / IV
Mercy
01.2018 - 01.2022
- Acted as Senior Paper Billing Lead and advanced to Billing Representative IV after receiving HFMA CRCR certification (July 2019)
- Led daily paper billing operations as Senior Paper Billing Lead, supporting billing staff and ensuring process efficiency
- Processed hospital and physician paper claims, primarily for workers' compensation and Medicaid/managed Medicaid payers
- Verified claims for required sterilization and hysterectomy consents and payer-specific medical record documentation, enhancing compliance
- Performed special handling of complex claim submissions beyond standard Billing Representative I scope
- Trained billing staff and developed workflow documentation to streamline operations and improve onboarding
- Supported early electronic workers' compensation workflows and claim attachment processes
Billing Representative I
Mercy
11.2014 - 01.2018
- Processed hospital and physician paper claims for primary, secondary, and tertiary insurance payers
- Supported accurate claim submission by ensuring required documentation was present for paper claims
- Maintained medical records in compliance with HIPAA and organizational standards
- Supported billing accuracy and documentation requirements
Data Entry / Medical Records Specialist
Pathology Services, Inc.
02.2008 - 11.2014
- Maintained and managed medical records, pathology slides, and confidential documentation in compliance with regulatory standards
- Processed Pap smear specimens using ThinPrep liquid-based cytology, operating laboratory equipment to prepare slides for pathologist review
- Assisted with specimen check-in and accessioning, ensuring accurate identification and documentation
- Distributed pathology and drug screen results to authorized recipients
- Performed medical transcription on a per-diem basis
- Created and maintained the pathologist's monthly schedule, coordinating on-site hospital coverage across multiple facilities
- Supported multi-facility operational logistics and executive-level administrative needs for the company's owner and president
Education
High School Diploma -
Oakville Senior High School
08.2004 - 05.2008
Completion Certificate - Broadcast Captioning & Court Reporting
South Technical High School
08.2006 - 05.2008
Skills
- Epic billing workflows
- Jopari claim attachments
- Claims Gatekeeper and Epic liaison support
- Up-front payer rejection analysis and resolution
- Hospital and physician billing
- Commercial payers, Medicaid, Managed Medicaid, Medicare Advantage and Workers' compensation payers
- SSI clearinghouse
- Paper-to-electronic billing conversion
- Medical record selection and attachment workflows
- Training documentation
- HIPAA compliance
Certification
HFMA Certified Revenue Cycle Representative (CRCR), 2019, Active
Timeline
Billing Analyst I
Mercy
01.2022 - Current
Billing Representative III / IV
Mercy
01.2018 - 01.2022
Billing Representative I
Mercy
11.2014 - 01.2018
Data Entry / Medical Records Specialist
Pathology Services, Inc.
02.2008 - 11.2014
Completion Certificate - Broadcast Captioning & Court Reporting
South Technical High School
08.2006 - 05.2008
High School Diploma -
Oakville Senior High School
08.2004 - 05.2008