Heather Gipson
Van Buren,AR
Summary
Dedicated professional with over 10 years of diverse experience in revenue cycle management, to include, Project Coordination, Site wide system training, and Compliance within the healthcare industry. Seeking to leverage strong communication skills, analysis abilities, and a passion for building community and strengthening engagement within the healthcare industry
Overview
13
13
years of professional experience
Work History
Patient Service Representative
Mercy
Fort Smith , Arkansas
03.2026 - Current
- Managed patient inquiries and resolved issues promptly and professionally.
- Assisted patients with appointment scheduling and registration processes.
- Coordinated communication between patients and medical teams to enhance understanding and care continuity.
- Educated patients on services, procedures, and insurance options to empower informed decision-making.
- Collaborated with healthcare staff to ensure accurate patient information flow.
- Maintained patient records in compliance with privacy regulations and policies.
- Utilized electronic health record systems for efficient data management tasks.
- Supported front desk operations by answering phones and greeting visitors warmly.
- Verified insurance information, collected payments, and scheduled appointments.
- Assisted with scheduling follow-up appointments according to provider availability.
- Entered patient demographic data into the electronic health record system.
- Ensured all necessary paperwork was completed prior to patient visits.
- Informed patients about payment options, billing policies, and procedures related to their visit or procedure.
- Reviewed patient accounts for accuracy on a regular basis.
- Provided support with various tasks such as scheduling tests, ordering supplies.
- Utilized technology and specialized software to maximize productivity.
- Collected patient co-pays at the front desk during check-in., deductibles, and other payments by ensuring accurate financial records.
- Prepared daily reports on registration activities, highlighting areas for improvement.
- Contributed to team meetings, sharing insights and strategies for improving patient access services.
Appeals Support Specialist (November 2024 - Presen
R1 RCM
Remote
11.2024 - 03.2026
- Reviewed and analyzed appeals for compliance with company policies and regulations.
- Analyze denied claims to identify underlying reasons and collaborate with insurance carriers to facilitate timely resolutions.
- Acted as an intermediary between insurance companies and customers by researching and assessing information to determine claim validity.
- Communicated with clients to gather necessary documentation for appeal process.
- Collaborated with legal teams to assess case validity and prepare responses.
- Managed case files and maintained accurate records in the database system.
- Coordinated with internal departments to ensure timely resolution of appeals.
- Facilitated meetings to discuss complex cases and strategize resolutions collaboratively.
- Implemented process improvements to streamline appeal review workflows efficiently.
- Developed processes and procedures for appealing denied claims that improved efficiency and effectiveness.
- Created training materials to improve staff understanding of appeals procedures, enhancing overall team competency.
- Participated in training sessions on new rules or regulations affecting the appeals process.
- Analyzed medical records to determine if further information was needed in order to process appeals.
- Compiled data from various sources in order to analyze trends associated with denials or other claim issues.
- Identified trends in the types of appeals received, and reported those findings to management.
- Researched complex cases involving multiple parties or multiple issues to provide accurate decisions on appeals.
- Retained strong medical terminology understanding in an effort to better comprehend procedures.
- Reviewed documentation for accuracy to ensure compliance with guidelines and appropriate coding.
- Drafted statements of loss to summarize payments, underlying policy coverages and damages.
- Partnered with provider relations staff to address and resolve disputes between providers and health plans regarding payment for services.
Assistant Facility Compliance and Privacy officer
Community Health Systems
fort smith , arkansas
04.2022 - 11.2024
- Conducted risk assessments to identify and mitigate data vulnerabilities.
- Monitored compliance with federal and state privacy laws to maintain regulatory standards.
- Reviewed and updated privacy-related documents to ensure compliance and accuracy.
- Developed privacy policies in compliance with healthcare regulations.
- Trained staff on best practices for handling patient information securely.
- Collaborated with IT to implement secure data management systems.
- Led privacy incident investigations to ensure thorough resolution processes.
- Drafted reports summarizing findings from investigations into suspected breaches of privacy protocols.
- Conducted internal audits to verify compliance with applicable laws and regulations related to data privacy.
- Reviewed, updated and maintained the organization's privacy policies and procedures.
- Assisted in responding to requests from individuals regarding their personal information held by the organization.
- Advised management on best practices for protecting sensitive customer data while ensuring regulatory compliance.
- Evaluated third-party services used by the organization for compliance with relevant standards concerning user privacy.
- Created a framework for collecting, using, sharing and disposing of personal information responsibly.
- Developed tools for tracking changes in legal requirements that affect how the organization manages customer data.
- Responded to privacy inquiries from patients and staff promptly.
- Provided assistance in resolving disputes between customers and staff over matters related to data protection rights.
- Communicated with external regulators regarding inquiries about the organization's handling of confidential information.
- Supported internal and external auditing teams conducting impartial compliance reviews.
- Issued clear warnings to violators, outlining infractions, penalties and remediation steps.
- Collected and reviewed data to identify potential compliance issues requiring further review.
- Responded promptly to complaints from customers about their personal data being mishandled by staff members.
Onboarding Training Analyst and Documentation spec
Community Health Systems
Fort Smith , AR
10.2018 - 04.2022
- Developed training materials for healthcare staff on operational procedures.
- Assessed training needs to identify gaps in employee skills and performance.
- Evaluated training programs to ensure alignment with organizational goals.
- Developed and implemented training programs to ensure employees had the necessary skills to perform their job duties.
- Coordinated training sessions, ensuring staff participation and engagement.
- Organized and facilitated classroom-style training sessions for new hires and existing staff members.
- Facilitated workshops on compliance and patient care standards for employees.
- Tracked trainee progress throughout programs. Offering tailored guidance to support development.
- Conducted individual and group assessments to identify areas of improvement in employee performance.
- Collaborated with department heads to identify skill gaps in teams.
- Implemented feedback systems to refine training content and delivery methods.
- Provided mentorship to new trainers on effective instructional techniques.
- Documented best practices for use by other trainers in the organization.
- Compiled comprehensive reports on employee training outcomes and progress.
- Researched new technologies related to corporate training initiatives.
- Drove changes to different areas of operations to align the company with HR strategies.
- Cultivated relationships with external vendors providing specialized services related to corporate training objectives.
- Analyzed data from surveys to determine if employee knowledge was increasing after completing a course or program.
- Designed instructional materials such as manuals, handbooks, practice tests, multimedia visual aids, and computer tutorials to support the learning process.
Benefit Verification Specialist
Community Health Systems
Fort Smith, Arkansas
06.2015 - 10.2018
- Verified patient benefits for accuracy and eligibility using electronic health records.
- Communicated effectively with patients regarding their coverage and benefits options.
- Collaborated with insurance providers to resolve discrepancies in benefit information.
- Documented verification processes in accordance with company policies and compliance standards.
- Trained new staff on benefits verification procedures and system navigation techniques.
- Adhered to HIPAA regulations when handling confidential patient information.
- Organized and prioritized daily workloads to ensure timely task completion. while meeting deadlines set by management.
- Created reports summarizing the status of pending benefit verifications.
- Collaborated with other departments to ensure proper data entry into the system.
Pre Registration Specialist ( March 2014 - June 20
Community Health Systems
fort smith , arkansas
03.2014 - 06.2015
- Streamlined patient registration process, improving efficiency and accuracy in data collection.
- Verified insurance information and patient demographics to ensure data integrity.
- Verified insurance coverage for incoming patients and ensured that all documents were accurate and up-to-date.
- Assisted patients with forms and registration inquiries, enhancing overall patient experience.
- Guided patients through completion of registration forms to ensure understanding.
- Coordinated communication between patients and healthcare providers, ensuring clarity and timely information exchange.
- Utilized electronic health record systems to update patient information promptly.
Education
High School Diploma -
Northside High School
Fort Smith 03-2013
Skills
- Electronic health records
- Insurance verification
- Patient eligibility verification
- Claims processing
- Patient scheduling
- Data management
- Quality assurance
- HIPAA compliance
- Operational efficiency
- Process improvement
- Team collaboration
- Time management
- Problem solving
- Attention to detail
Projects and Oversight
- 2015- 2016- Worked with VP, Pre Arrival Units, and Compliance to update and create training materials for Tennova onsite registration after rending issues.
- 2017- Worked with Follow-up leadership to identify ongoing trends within the Other Government payers to identify trends for denied Triwest and Tricare Procedures. Identified diagnosis, implemented billing edits, and developed associate training to minimize denials withing this department
- 2021 - Collaborated with Patient Access Center, to develop and implement comprehensive remote New Hire Training materials. Created presentations for Revenue Cycle Process and designed departmental training including system navigation.
- 2022- Worked with the billing department to identify edits and trends for trending DRG downgrades specific to Missouri Hospitals
- 2023-2024- Worked with Upper leadership to create 100% virtual Onboarding training for all areas of Revenue Cycle.
- Interim Compliance and Privacy / Training and Development Manager : led weekly team meetings, conducted one - on - one sessions to support team members during a company merge and implemented and executed departmental initiatives to enhance operational efficiency.
Timeline
Patient Service Representative
Mercy
03.2026 - Current
Appeals Support Specialist (November 2024 - Presen
R1 RCM
11.2024 - 03.2026
Assistant Facility Compliance and Privacy officer
Community Health Systems
04.2022 - 11.2024
Onboarding Training Analyst and Documentation spec
Community Health Systems
10.2018 - 04.2022
Benefit Verification Specialist
Community Health Systems
06.2015 - 10.2018
Pre Registration Specialist ( March 2014 - June 20
Community Health Systems
03.2014 - 06.2015
High School Diploma -
Northside High School