Heather Magness
Ooltewah,TN
Summary
Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
18
18
years of professional experience
Work History
Payer Fee Schedule Specialist
National Seating and Mobility
Chattanooga, TN
01.2015 - Current
- Perform analysis of medical payment rates and fee schedules as needed
- Ensure fee schedules are loaded according to the provider contract, including analysis of implemented contracts
- Responsible for researching and determining the proper fee schedule
- This includes having one or more states assigned to this position
- All procedures that fall under that states fee schedule is required to be analyzed and interpreted
- Responsible for the identification, correction, and root cause analysis of fee schedule load and reimbursement problems which includes partnership with various departments within NSM
- Analytic, problem solving, technical skills and attention to detail are required
- Candidates will be expected to identify areas of improvement within the scope of this function and work with Payer Relations leadership to document and implement change
- Maintain accuracy and integrity of data on the company intranet
- Communicate directly with payers via phone, email, or any other means necessary to gather necessary information
- Must maintain regular and predictable attendance
- Assume other duties and responsibilities as assigned
- Individuals will be expected to maintain a professional work environment at all times.
Medical Billing Coordinator
East Brainerd Internal Medicine
Chattanooga, TN
05.2006 - 01.2015
- Managing and performing all insurance and patient billing and collections for practice
- Posting of all insurance and patient payments with daily balancing
- Resolving issues for patients regarding their insurance coverage, billing, referrals and office staff
- Filling in for receptionist: scheduling, checking patients in and out, medical records request, and answering multiline phone system, updating demographics, verifying insurance and appointment reminders
- Credentialing for physicians and insurance contracting for physicians and facility
- Training employees
- Provide support for employees with system and equipment issues
- Preparing and making weekly deposits Prepare AR reports and practice issue reports to discuss in provider meetings
- Ordering supplies
- Liaise with vendors regarding equipment, supplies and services
- Meetings with insurance representatives
- Increased Revenue and Excellent Customer Service
Reimbursement Specialist
National Seating and Mobility
Chattanooga, TN
- Performs timely and accurate follow-up on claims to payers and patients following prescribed policies and procedures
- Responsible for preparing and submitting timely and accurate rebilled claims and initial billed secondary/tertiary claims to payers following prescribed policies and procedures
- Enters certain demographic data into the billing and collections software following prescribed policies and procedures
- Generates claims for both electronic and/or hard-copy submission
- Generates Missing Information Requests (MIR) following prescribed policies and procedures
- Identifies variances between booked revenue and expected reimbursement to facilitate accurate reimbursement of claims as defined by contracts, and state and federal law
- Identifies and reports violations of NSM Credit Policy
- Participates in collecting and documenting payer specific claims processing rules, practices and guidelines to contribute to, and maintain, the currency and accuracy of payer requirements for NSM personnel
- Complies with and supports department and organizational policies and procedures
- Assumes other duties and responsibilities as assigned.
Quality Auditor
National Seating and Mobility
Chattanooga, TN
Education
Skills
- Microsoft Word
- Microsoft Excel
- Adobe
- Medical Manager Billing Software
- Medisoft CPU Billing Software
- Medsym Solutions
- BCS (Billing and Collections System)
Accomplishments
- Shining Star Award for March 2024: Recognizing my passion, dedication and commitment to the clients.
Timeline
Payer Fee Schedule Specialist
National Seating and Mobility
01.2015 - Current
Medical Billing Coordinator
East Brainerd Internal Medicine
05.2006 - 01.2015
Reimbursement Specialist
National Seating and Mobility
Quality Auditor
National Seating and Mobility
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