Heather Richards
Knightdale,NC
Summary
Efficient Revenue Cycle Representative known for productivity and ability to complete tasks swiftly. Specialize in medical billing, coding accuracy, and claims processing with strong analytical skills. Excel in communication, problem-solving, and teamwork to achieve financial objectives and enhance revenue cycle operations.
Overview
22
22
years of professional experience
Work History
Revenue Cycle Representative
UNC Rex Health Care
Morrisville, NC
01.2015 - Current
- Reviewed patient accounts for accuracy and completeness of information.
- Resolved billing discrepancies through research and analysis.
- Processed claim denials and appeals in accordance with established procedures.
- Conducted follow-up on unpaid or partially paid claims.
- Reconciled payments received from insurance companies with expected amounts due.
- Prepared reports to track aging of receivables and other metrics.
- Identified coding errors, corrected them, and resubmitted claims to payers as needed.
- Provided customer service support by responding to inquiries from patients, physicians, and insurance carriers via telephone or email.
Patient Financial Counselor
The Outsource Group
Charlotte, NC
03.2010 - 12.2014
- Counseled patients on financial obligations associated with their medical care.
- Analyzed patient account data and determined payment plans based on individual needs.
- Provided clear explanations of billing policies and procedures to both internal and external customers.
- Identified potential bad debt write-offs by analyzing patient accounts.
- Processed credit card payments accurately and securely.
- Performed follow up calls to collect outstanding balances from patients who were unable to make payments at time of service.
Patient Service Associate
Duke Gastroenterology
Raleigh, NC
05.2008 - 02.2010
- Greeted and provided assistance to patients upon arrival at the clinic.
- Assisted with patient check-in and registration by verifying insurance coverage, collecting co-payments, and scheduling follow-up appointments.
- Answered incoming calls from patients, answered questions about services offered, and directed inquiries to appropriate personnel.
- Performed administrative duties such as filing medical records, completing paperwork, and updating patient databases.
- Scheduled laboratory tests for referring physicians based on their orders.
Medical Claims Examiner
Physician Weblink
Durham, NC
10.2006 - 04.2008
- Reviewed and processed medical claims for accuracy and completeness according to established guidelines.
- Submitted appeals to payers when necessary to resolve denied or underpaid claims.
- Analyzed provider contracts to ensure proper reimbursement levels were achieved.
- Reviewed claims for accuracy before submitting for billing.
Claims Analyst
Health Net
Shelton, CT
09.2002 - 08.2006
- Reviewed customer claims, identified discrepancies and determined appropriate course of action.
- Participated in meetings with internal departments or external vendors as necessary to discuss disputed claims or other related matters.
- Managed escalated cases involving high-value claims or multiple parties involved.
- Conducted investigations to gather evidence in support of claims resolution.
Education
High School Diploma -
Central High School
Bridgeport, CT05-1999
Some College (No Degree) - Liberal Arts and General Studies
Housatonic Community College
Bridgeport, CTSkills
- HIPAA Compliance
- Revenue Cycle Management
- Patient Registration
- Medical coding knowledge
- Medicare and Medicaid regulations
- Claim submission
References
References available upon request.
Timeline
Revenue Cycle Representative
UNC Rex Health Care
01.2015 - Current
Patient Financial Counselor
The Outsource Group
03.2010 - 12.2014
Patient Service Associate
Duke Gastroenterology
05.2008 - 02.2010
Medical Claims Examiner
Physician Weblink
10.2006 - 04.2008
Claims Analyst
Health Net
09.2002 - 08.2006
High School Diploma -
Central High School
Some College (No Degree) - Liberal Arts and General Studies
Housatonic Community College
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