Laura Hiatt
Aurora,CO
Summary
Denials specialist with expertise in appeal preparation, billing dispute resolution, and insurance verification. Skilled in negotiating claim resolutions and collaborating with healthcare teams to improve financial outcomes. Proven track record of enhancing revenue through effective claims management and strategic problem-solving.
Overview
13
13
years of professional experience
Work History
Denials Specialist
CommonSpirit Health
Aurora, Colorado
12.2023 - Current
- Reviewed denial claims to identify patterns and root causes for enhanced outcomes.
- Prepared and submitted appeal letters along with necessary documentation to overturn unjustified denials.
- Negotiated claim resolutions through effective communication with payers.
- Communicated with providers on denied claims and appeals processes, ensuring clarity and timely resolutions.
- Monitored accounts for potential payment resolutions or appeal opportunities.
- Resolved billing disputes between providers and third-party payers promptly.
- Collaborated with healthcare teams to resolve billing discrepancies efficiently.
- Coordinated with billing department to ensure timely resubmission of corrected claims.
Patient Account Representative II
SCL Health
Broomfield, CO
03.2021 - 12.2023
- Managed high-value, sensitive accounts, achieving optimal financial performance through proactive oversight.
- Resolved billing, payment, and contract issues with payers for timely reimbursements.
- Reviewed aging accounts receivable, identifying outstanding payments and discrepancies to facilitate timely resolution.
- Verified insurance payments for accuracy, ensuring compliance with contractual agreements.
- Appealed denied claims with insurance companies to secure rightful reimbursements.
- Processed bills manually and electronically, streamlining workflows to improve operational efficiency.
- Assisted internal and external customers by providing information and resolving inquiries.
Patient Account Representative
SCL Health
Broomfield, Colorado
08.2017 - 03.2021
- Examined third-party payer denials to identify reimbursement solutions, enhancing claim recovery.
- Utilized Epic system for processing insurance claims, achieving accurate reimbursements.
- Conducted research into patient account discrepancies for effective resolution.
- Scrutinized EOB statements from insurance companies for accuracy against charges.
- Corrected documentation issues to ensure accurate claim outcomes through methodical resolution practices.
- Initiated appeals when warranted based on research conducted on denied claims.
- Matched payments with outstanding invoices to confirm accurate credit and debit postings, facilitating streamlined account reconciliation.
- Adhered to privacy regulations regarding confidential health information throughout processes.
Claims Auditor Lead
PharMerica Pharmacy
Longmont, CO
05.2016 - 08.2017
- Audited pharmacy claims for accuracy and compliance with regulations.
- Maintained comprehensive audit records and findings for internal reporting, ensuring transparency and accountability.
- Trained staff on effective claims processing and audit procedures.
- Communicated audit results to management, providing actionable recommendations for best practices.
- Evaluated policies for adherence to state and federal laws, assessing accuracy.
- Analyzed claims processing errors to identify issues and initiate corrective actions.
- Trained staff on claims processing and audit procedures effectively.
- Investigated questionable claims to verify payment authorization, mitigating risk of potential fraud.
Claims Auditor
Pharmerica Pharmacy
Longmont, Colorado
02.2014 - 05.2016
- Managed appeals process with insurance companies to secure claim payments.
- Researched claims to accurately determine payment responsibility.
- Implemented measures to streamline claims management operations.
- Partnered with auditor lead to ensure timely completion of audits.
Education
Bachelor of Science - Criminal Justice
Metropolitan State University of Denver
Denver, CO05-2013
Skills
- Appeal preparation
- Appeals processing
- Claims management
- Claims analysis
- Billing dispute resolution
- Insurance verification
- Claim data analysis
- Medicare insurance expertise
- Attention to detail
Timeline
Denials Specialist
CommonSpirit Health
12.2023 - Current
Patient Account Representative II
SCL Health
03.2021 - 12.2023
Patient Account Representative
SCL Health
08.2017 - 03.2021
Claims Auditor Lead
PharMerica Pharmacy
05.2016 - 08.2017
Claims Auditor
Pharmerica Pharmacy
02.2014 - 05.2016
Bachelor of Science - Criminal Justice
Metropolitan State University of Denver