Summary
Overview
Work History
Education
Skills
Timeline
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Laura Henderson

Houston

Summary

6+ years initiative-taking and results-oriented revenue cycle specialist with a proven track record of exceeding collection goals, improving claim accuracy, and streamlining revenue cycle processes. Adept at utilizing various follow-up techniques, ensuring accurate insurance verification and claim submission, and resolving patient billing inquiries.

Overview

6
6
years of professional experience

Work History

Insurance Follow-Up Representative

Heart & Vascular Partners
06.2021 - 05.2024
  • Daily communication with insurance/payers either commercial or government to resolve discrepancies towards reimbursement on claims
  • Examined and worked on claims needing medical record request from payers
  • Track common claim errors, identify and report inaccurate reimbursement and contractual trends
  • Perform follow up actions and documents follow up activities, conversations with payers
  • Investigate and coordinates insurance benefits for insurance claims across multiple lines
  • Daily communication with insurance companies and other commercial insurers to address coordination of benefits and claim resolution
  • Contact patients if claim is missing correct information or member id is incorrect for claim to process
  • Work within payer portals and interact with third-party payors and patients to resolve account balances
  • Sets follow up activities based on the status of claim
  • Identified billing errors, underpayment or overpayment and resolved them accordingly
  • Notating accurate information on the status on claims stated by payer and finding possible resolution for proper reimbursement
  • Review, analyze, resolve, and trend for complex claims issues and payer behavior using Client billing system, payor portals, calling the payer, and EOB review
  • Review daily clearinghouse rejections, resolving, and resubmitting accounts
  • Post adjustments and collection of medicare, medicaid, and commercial insurance payers
  • Report appeals to supervisor/manager to review if there is a strong supporting document that should be escalated at payer level
  • Observed legal and ethical guidelines of HIPAA for safeguarding patient and company confidential and proprietary information
  • Review aged accounts and take steps to resolve for payment by contacting payors for claim status, process rebilling requests and escalating issues when needed
  • Collect patient co-pays/coinsurance/deductible amounts due after insurance.

Revenue Cycle Specialist

Coventry Healthcare
03.2020 - 06.2021
  • Recognize and find resolution to potential issues within claims
  • Work and managed claims from all aging buckets including posting and appeals
  • Contacting/sending letter to patients for patient pending balance which is patient responsibilities applied to either copay, co insurance or deductible
  • Sending appeals to appropriate payers depending on denial reason for reimbursement of claims
  • Ensuring claims are billed at appropriate time to avoid going past timely filing
  • Contacting payer for status updates on claims and probing live agent for accurate claim information
  • Research missing payments and secure documents needed for posting
  • Contact patient for COB update when necessary
  • Contacted responsible parties for past due debts
  • Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites
  • Outbound calls to insurance companies to verify coverage, eligibility as well as claim status
  • Reviewed EOBs for correct payment, deductible, adjustments and denials
  • Investigates and coordinates insurance benefits for claims across multiple service lines.

Customer Service Representative

DaVita Kidney Care
01.2018 - 03.2020
  • Handled customer inquiries and suggestions courteously and professionally
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly services
  • Accurately capture conversations with customers and notate correctly
  • Resolve customers issues in regards to their benefits and eligibility
  • Actively listened to customers, handled concerns quickly and escalated major issues to supervisor
  • Answered constant flow of customer calls with minimal wait times
  • Answered customer telephone calls promptly to avoid on-hold wait times
  • Managing customers medicaid accounts.

Education

High School Diploma -

Skyline High School
Dallas, TX
05.2015

Skills

  • Revenue Cycle
  • Account Receivable (AR)
  • Collections
  • Insurance Follow-Up
  • Claim Follow-Up
  • Patient Billing
  • Verification
  • Negotiation
  • Communication
  • Customer Service
  • Soft Skills
  • Problem-Solving
  • Data Entry
  • HIPAA Compliance
  • Hospital Billing (UB04)
  • Medical Billing & Coding (E/M, CPT, ICD-10)
  • Healthcare Claims Processing
  • Claims Review
  • Denial Management
  • Insurance Verification & Reimbursement (Medicare, Medicaid, Commercial)
  • Patient & Insurance Inquiry Resolution (Phone & Email)
  • Revenue Cycle Management (RCM) Processes
  • Claims Management & Follow-up (Submission, Denial Resolution)

Timeline

Insurance Follow-Up Representative

Heart & Vascular Partners
06.2021 - 05.2024

Revenue Cycle Specialist

Coventry Healthcare
03.2020 - 06.2021

Customer Service Representative

DaVita Kidney Care
01.2018 - 03.2020

High School Diploma -

Skyline High School

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Laura Henderson