Heather McClelland
Rochester,NH
Summary
Experienced Reimbursement Analyst successful at managing high volume of clients.. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering 13 years of experience and willingness to take on any challenge.
Overview
13
13
years of professional experience
Work History
Reimbursement Analyst
Healthcare Administrative Partners
01.2012 - Current
- Coordinated with clients, staff, and supervisor to resolve payment questions and issues
- Responded to vendor questions and daily queries from internal departments within twenty-four to forty-eight hours
- Verified payment postings were performed accurately and timely for all payments, denials, refunds, recoupments, adjustments, and correspondence daily
- Reviewed daily bank deposit which included bank statements, emails from client and all other methods through which client provided deposit information
- Ensured all appropriate payments and electronic fund transfers are properly recorded on the appropriate spreadsheet
- Reconciled daily and monthly postings against audit journals, balancing to cash logs and bank statement
- Monitored outstanding variances of unposted cash to ensure end of month deadlines will be met, reported to supervisor when variances were greater than forty-eight hours of unposted cash
- Monitored and balanced payment and cash logs
- Monitored outstanding variance of unposted cash to ensure end of month deadlines will be met.
Reimbursement Supervisor
Healthcare Administrative Partners
02.2023 - 11.2023
- Scheduled team assignments for daily and monthly functions and ensured that employees understood their responsibilities and delegated tasks
- Monitored team productivity and provided constructive feedback, training, mentorship, and corrective counseling when necessary
- Ran and analyzed department metric reports and monitored employee assignments to ensure accurate and timely completion
- Informed upper management of problems before they affected productivity/AR/Cash
- Kept employees informed of process changes and general department and company updates
- Communicated professionally and effectively with clients, client service managers, staff, and vendors
- Facilitated and ran team meetings, brainstorming and problem-solving sessions
- Maintained timekeeping and personnel records
- Timely completed performance evaluations for team members.
EDI Enrollment lead
Healthcare Administrative Partners
01.2020 - 02.2023
- Mentored team members including training
- Configured Electronic Remittance Advice (ERA/835) through clearinghouse or other source as appropriate
- Configure Electronic Funds Transfer (EFT/ACH) with payers
- Initiated telephone calls to payers with respect to provider ERA/EFT set up
- Gained and maintained administrative rights and facilitated necessary access for staff within HAP office to websites required to access 835’s and other ERA’s not available through the clearinghouse
- Managed existing ERA/EFT connections; troubleshot and resolved issues with all EDI functions related to ACH/835 transactions
- Processed all paper claims
- Identified and created electronic opportunities for reduction of check or credit card (VCC) payments
- Acted as point person for any new client onboarding regarding ERA/EFT enrollment.
Cash Poster
03.2011 - 01.2012
- Monitored Balances Daily /Monthly
- Kept Detailed records of all accounts
- Posted received PT and insurance checks EFT and Credit Card payments.
Education
No Degree - Certified Billing & Coding Specialist
Blended Solutions Technical Institute
Manchester NH07.2010
High School Diploma -
Spaulding High School
Rochester, NH06.1993
Skills
- Upbeat and positive personality
- Proactive self-starter
- Efficient and detailed-oriented
- HIPPA compliant
- Calm and professional under pressure
- Fast and concise in data entry
- Proficient in Microsoft Office, Excel and Teams
- Knowledgeable in Imagine Billing software
- Experienced in GE Centricity billing Software
- Excellent attention to detail
- Experienced with multiple payer websites Ex: Instamed, Patient Pay, Payspan, Optum, Availity, CHC
- Experienced with pulling bank statements for multiple Banks Ex: WSFS, TD Bank, BOA, Trustmark and many more
- Experienced with pulling lockbox batches from multiple lockbox sites Ex: ONB, WSFS, Trustmark, Wells Fargo & more
Timeline
Reimbursement Supervisor
Healthcare Administrative Partners
02.2023 - 11.2023
EDI Enrollment lead
Healthcare Administrative Partners
01.2020 - 02.2023
Reimbursement Analyst
Healthcare Administrative Partners
01.2012 - Current
Cash Poster
03.2011 - 01.2012
No Degree - Certified Billing & Coding Specialist
Blended Solutions Technical Institute
High School Diploma -
Spaulding High School