Heather Goeller
Revenue Cycle And Billing Specialist
Raleigh,NC
Summary
Methodical Revenue Cycle Specialist with strong attention to detail and in-depth understanding of billing procedures. Excellent planning and problem-solving abilities. Prepared to bring over 20 years of related experience to a dynamic position with room for career growth.
Overview
22
22
years of professional experience
Work History
Senior Revenue Cycle Specialist
Rex Hospital
Raleigh, NC
04.2015 - 11.2021
- Processed Late Charge/Credits, reconciled account discrepancies
- Met productivity goals at 200% weekly
- Processed and split billing of Provider Liable claims
- Created Related Accounts for proper billing of Ambulance charges
- Analysis and processing of Claim Skip Report
- Reviewing, verifying and processing billing for Research and Clinical Trial claims
- Produced Daily Billing reports
- Collaborated with other departments to reconcile billing/denial issues
- Analysis of claims in Stop Bill and DNB
- Consolidated financial data and materials for key leadership meetings.
- Mentored and trained employees
- Extensive knowledge and proficiency in EPIC and SSI
- Identified and resolved payment issues between patients and providers.
- Monitored and analyzed financial and operational data trends.
- Improved financial status by analyzing results, monitoring variances and recommending actions to management staff.
- Researched and verified insurance coverage.
- Contacted responsible parties for past due debts.
- Created and maintained precise and accurate reports.
- Balanced and reconciled accounts.
Medicare/Government billing specialist
Rex Hospital
Raleigh, NC
03.2012 - 04.2015
- Billing for out and inpatient services
- Appealing denied claims, filing corrected claims
- Collaborated with other departments on coding/billing issues
- Proficient in DDE and CCSM denial/RTP workflow
- Completed keeping Work Ques current and timely
- Mentored and supported employees
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Collected payments and applied to patient accounts.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
Front Desk
Triangle Physicians Network
Morrisville, NC
10.2010 - 03.2012
- Scheduling for multi physician practice
- Insurance verification
- Obtain and track referrals and authorizations
- Billing & Coding ICD-9 and CPT
- Implement and create Policy/Procedure and forms for practice
- End of day/month closing
- Answered multi-line phone system to respond to inquiries and transfer calls to correct departments and personnel.
- Greeted patients at front desk and engaged in pleasant conversations while managing check-in process.
- Maintained files and records by implementing effective filing systems that boosted efficiency and organization.
- Confirmed important personal and payment information for compliance with security and payment card industry standards.
- Trained new team members on company procedures, customer service and issue resolution.
- Used quick response and dynamic service skills to build relationships with patients and improve customer retention rate.
- Kept accounts in balance and ran daily reports to verify totals.
- Entered and updated sensitive customer information during check-ins.
Office Manager
Colville Trucking Co
Raleigh, NC
09.2008 - 08.2009
- Managed 8 Trucks/Drivers
- Implementing DOT regulations
- Coordination truck loads and delivery schedules
- Billing
- End of month closing
- Maintained computer and physical filing systems.
- Established workflow processes, monitored daily productivity and implemented modifications to improve overall performance of personnel.
- Updated reports, managed accounts and generated reports for company database.
- Optimized organizational systems for payment collections, AP/AR, deposits and record keeping.
- Coached new hires on company processes while managing employees to achieve maximum production.
Administrative Assistant to the Director
AdvoCare, Inc./Town Total Nutrition
Farmingdale, NY
10.2003 - 08.2007
- Restocked supplies and submitted purchase orders to maintain pharmacy inventory.
- Edited documents to improve accuracy of language, flow and readability.
- Interacted with discharge planners and Physicians to purchase and set up equipment and services.
- Intake for new patients
- Obtaining authorization and pre-certification
- Insurance verification
- Nursing care coordination
- Report lab results to ordering physician
- Patient Plan of Treatment
- Track patient therapy, therapy changes and wasted doses
- Delivery and pick up coordination
- Manage accounts receivable
- Coding CPT and ICD-9
- Executed record filing system to improve document organization and management.
Medicare Specialist
Advanced Healthcare Resources
Hauppauge, NY
10.2001 - 11.2002
- Prepared outstanding claims reports and end of month closing reports
- Processed Medicare Pre-submission and Validation reports
- Correct ICD-9 and CPT coding and appeal denied claims
- Collaborated with clients to resolve account issues and trouble shoot system and program errors
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Collected payments and applied to patient accounts.
- Adhered to established standards to safeguard patients' health information.
- Orchestrated payment posting, accounts receivables and collections.
Medicare/Medicaid Billing Supervisor
East Meadow Management Group
Westbury, NY
03.1998 - 10.2001
- Supervised 7 administrative team members and provided constructive feedback, resulting in higher morale and increased employee retention.
- Train, oversee and delegate work to employee
- Run tape submissions to Medicare and Medicaid
- Follow up and appeals on outstanding/denied claims
- Update credentialing and group enrollment for providers
- Performed account reconciliations and resolved variances.
- Developed and implemented improvements to billing system to maximize efficiency, reduce delinquency and increase accuracy.
- Oversaw financial operations, producing invoices, processing payments and preparing deposits.
- Identified, researched and resolved billing variances to maintain system accuracy and currency.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Coordinated individual duties after careful evaluation of each employee's skill level and knowledge.
Account Representative
Intertech Penta Group
Syosset, NY
09.1996 - 03.1998
- Cardiology Unit
- Worked in the following departments: data entry, billing, cash posting, follow up and appeals
- Handled all Medicare, Medicaid, Commercial, NF and WC correspondence
- Corresponded with patients regarding insurance questions
- Verified insurance coverage and obtained authorization
Education
Associates Degree - Occupational Health
New York College of Health Professions
Syosset, NYA+ Certified Professional, CompTIA -
Hendricks Institute
Lindenhurst, NYCertificate in Windows 2000 Professional -
Hendricks Inst
Lindenhurst, NY01-2001
Certificate in Windows 2000 Server -
Hendricks Inst
Lindenhurst, NY01-2001
Certificate in Windows 2000 Network Infrastructure Admin -
Hendricks Inst
Lindenhurst, NY01-2001
Certified Medical Coding Specialist -
Molloy College
Rockville Centre, NYCertified Medical Administrative Assistant -
Molloy College
Rockville Centre, NYCertificate in Computerized Billing -
Molloy College
Rockville Centre, NY01-1996
Certificate in Hospital Billing -
Molloy College
Rockville Centre, NY01-1996
Certificate in Physician Billing I -
Molloy College
Rockville Centre, NY01-1996
Certificate in Physician Billing II -
Molloy College
Rockville Centre, NY01-1996
Certificate in ICD-9 Coding -
Molloy College
Rockville Centre, NY01-1996
Certificate in CPT-4 Coding -
Molloy College
Rockville Centre, NY01-1996
Certificate in Anatomy And Physiology -
Molloy College
Rockville Centre, NY01-1996
Certificate in Medical Terminology -
Molloy College
Rockville Centre, NY01-1996
Skills
- Financial and operational reporting
- Analyzing claims
- Debt collection procedures
- Managing records
- Interpersonal Communication
- Revenue Cycle Management
- Insurance Benefits Understanding
- HIPAA Regulations
- Medical Terminology Knowledge
- Team Training and Mentoring
- EPIC and SSI Proficiency
- Account reconciliation specialist
Timeline
Senior Revenue Cycle Specialist
Rex Hospital
04.2015 - 11.2021
Medicare/Government billing specialist
Rex Hospital
03.2012 - 04.2015
Front Desk
Triangle Physicians Network
10.2010 - 03.2012
Office Manager
Colville Trucking Co
09.2008 - 08.2009
Administrative Assistant to the Director
AdvoCare, Inc./Town Total Nutrition
10.2003 - 08.2007
Medicare Specialist
Advanced Healthcare Resources
10.2001 - 11.2002
Medicare/Medicaid Billing Supervisor
East Meadow Management Group
03.1998 - 10.2001
Account Representative
Intertech Penta Group
09.1996 - 03.1998
Associates Degree - Occupational Health
New York College of Health Professions
A+ Certified Professional, CompTIA -
Hendricks Institute
Certificate in Windows 2000 Professional -
Hendricks Inst
Certificate in Windows 2000 Server -
Hendricks Inst
Certificate in Windows 2000 Network Infrastructure Admin -
Hendricks Inst
Certified Medical Coding Specialist -
Molloy College
Certified Medical Administrative Assistant -
Molloy College
Certificate in Computerized Billing -
Molloy College
Certificate in Hospital Billing -
Molloy College
Certificate in Physician Billing I -
Molloy College
Certificate in Physician Billing II -
Molloy College
Certificate in ICD-9 Coding -
Molloy College
Certificate in CPT-4 Coding -
Molloy College
Certificate in Anatomy And Physiology -
Molloy College
Certificate in Medical Terminology -
Molloy College
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