Linda "Marie" Ransleben
Fredericksburg,TX
Summary
- Seasoned administrative and healthcare professional in several aspects of healthcare ranging from Customer Service/Claims Analyst/Team Lead/Supervisor Support to generalized Coding.
- Professional in claims management, equipped to drive accurate and efficient claim resolutions. Proven track record in handling diverse cases and ensuring compliance with regulatory standards. Known for strong team collaboration and adaptability, bringing valuable problem-solving skills and reliability to every project.
- Business-minded claims examiner with exemplary skills in customer service, time management and service coordination. Bringing over 15 years of related experience combined with superior mathematical abilities. Pursuing similar position with expanding insurance company.
Overview
2026
2026
years of professional experience
Work History
Realtor
Fathom Realty, Shario Rios, Broker
03.2005 - 08.2025
- Credentials include Texas Affordable Housing Specialist, Short Sales/Foreclosure Sales, Seller Representative, Residential Construction Consultant, Graduate Realtor Institute.
- Specializing in Residential, Land/Ranch, and Leases. Includes all phases of sales – marketing, accounting.
- Negotiated contracts to facilitate property transactions and ensure client satisfaction.
- Coordinated property listings and marketing strategies to enhance visibility and attract buyers.
- Coordinated various aspects of real estate transactions such as inspections, appraisals, and financing arrangements, minimizing delays and challenges for clients.
Patient Benefits Representative
Texas Oncology (Contracted W/Insight Global), Angie Santos - Supervisor
02.2025 - 07.2025
- Advised patient on financial matters related to treatment, ensuring informed decisions.
- Created precise estimages for treatment expenses.
- Held review meetings with patient to finalize estimates and secure signatures.
- Reviewed daily reports on appointments to through Availity to confirm patient insurance activation,, type, referral and pre auth status.
- Also, make sure all patients insurance is loaded in Athena correctly and active for billing.
- That all procedures that need authorization are attached to the appointments.
- Review patients as they come through a system for possible drug assistance, copay assistance or grants/foundation funding.
- Running batches daily for balancing.
- Established a positive rapport with patients during encounters while maintaining strict confidentiality standards as required under HIPAA regulations.
- Conducted comprehensive patient intake interviews to assess financial needs and determine appropriate benefit programs or assistance options.
- Provided exceptional customer service during high-stress situations, displaying empathy and professionalism when addressing sensitive patient concerns.
Remote Claims Examiner
Guidewell/Florida Blue Dba Webtpa -
09.2023 - 02.2024
- Claims processing adjudication
- Analyzing appeals, and pre-authorized services, adjustments-overpayments/underpayments
- Broad knowledge of documentation requirements, communication logs, appeals correspondence, pending claims requiring additional information.
- Utilized FACETS database software. and attention to individual plan details for accurate payment of claims. Training in new plans and auto adjudication improvement of workflow.
- Training in setting up systems/database software to pay according to individual plan specifications.
- General knowledge of company software for all phases of the claims processing.
- Work closely with all interrelated departments on assigned projects.
Independent Contractor for Complaint Appeals Board
Blue Cross/Blue Shield - Danielle Peters, Director of QA
07.2018 - 12.2023
- Escalated complaint review by all appropriate parties to arbitrate and review file documentation to process and make recommendations based on Plan provisions or have been paid according to plan or consider if this is out of plan mileage range or if an exception should be made and consideration be given as transitional care, etc.
- Attend CQIC monthly and Consumer Appeals telecast meeting to review meeting reports on monthly, quarterly reports by departments reporting to Clinical Director. Reports include systems, trends, and turnaround times, new plan products, and services. listen and suggest recommendations and contribute on opinions
- Monthly CQIC and as-requested Consumer Appeals meetings (remotely).
Remote-Claims Analyst
Boon-Chapman - Adam Dominguez, Manager
11.2021 - 09.2022
- Claims processing adjudication
- Analyzing appeals, and pre-authorized services, adjustments-overpayments/underpayments
- Broad knowledge of documentation requirements, and communication logs
- Project management using FACETS database software. and attention to individual plan details for accurate payment of claims.
- Training in new plans and auto adjudication improvement of workflow.
- Training in setting up systems/database software to pay according to individual plan specifications.
- General knowledge of company software for all phases of the claims processing.
- Work closely with all interrelated departments on assigned projects.
Pathology Lab Assistant
Pathology Reference Lab, Carl Evans, MD
04.2005 - 05.2006
- Prep and collections of surgical specimens from hospitals departments/individual physicians; for slide review by pathologist analysis.
- Knowledge of Hospital Billing system for documentation and billing purposes.
- Implemented a tracking system for specimen management, enhancing accountability and traceability within the lab.
- Supported efficient patient care by processing tissues quickly for analysis while adhering to strict quality control measures at every stage of preparation.
Claims Manager/Collections, Independent Contractor- Self Employed
Collection Solutions, Inc. - Partnership
2003 - 2005
- Knowledge of HIPAA regulations, ICD-9, CPT, HCPCS and Revenue coding to bill and rebill corrected healthcare claims including Physician healthcare, Personal Injury Protection, Workers Comp and Healthcare claims for HCFA and UB billing, electronically and paper claims.
- Documentation of all corrections, rebills, corrected claims.
- Meet with clients to acquire possible new clients.
- Accounting for company, accounts receivable and payables.
- Enhanced customer satisfaction with timely and accurate claims resolutions.
- Documented and communicated timely claims information while supporting accurate outcomes.
- Gathered sensitive information to update customer profiles and help with appeals process.
Sr. Claims Analyst
Fiserv (Benefit Planners)- Michael New, Lee DeLuna, Supervisors
01.1999 - 01.2003
- Claims processing adjudication
- Analyzing appeals, and pre-authorized services, adjustments-overpayments/underpayments
- Broad knowledge of documentation requirements, and communication logs
- Project management using FACTS database software. and attention to individual plan details for accurate payment of claims.
- Training on new plans and auto adjudication improvement of workflow.
- Training in setting up systems/database software to pay according to individual plan specifications.
- General knowledge of company software for all phases of the claims processing.
- Work closely with all interrelated departments on assigned projects.
- Developed training programs for junior analysts, fostering skill development and knowledge sharing.
- Provided exceptional customer service by addressing client concerns promptly and maintaining open lines of communication throughout the claims process.
- Improved customer satisfaction by consistently resolving complex claims in a timely and professional manner.
Education
Associate Degree - Incomplete - Business Management
05-2002
Realtor - Real Estate
05-2006
Medical Coding
09-2021
Skills
- Client relations
- Contract negotiation
- Strong negotiation skills
- Comparative market analysis
- Database management
- Sales negotiation
- Social media marketing
- Critical Thinking
- Decision Making
- Professionalism
Timeline
Patient Benefits Representative - Texas Oncology (Contracted W/Insight Global), Angie Santos - Supervisor
02.2025 - 07.2025
Remote Claims Examiner - Guidewell/Florida Blue Dba Webtpa -
09.2023 - 02.2024
Remote-Claims Analyst - Boon-Chapman - Adam Dominguez, Manager
11.2021 - 09.2022
Independent Contractor for Complaint Appeals Board - Blue Cross/Blue Shield - Danielle Peters, Director of QA
07.2018 - 12.2023
Pathology Lab Assistant - Pathology Reference Lab, Carl Evans, MD
04.2005 - 05.2006
Realtor - Fathom Realty, Shario Rios, Broker
03.2005 - 08.2025
Sr. Claims Analyst - Fiserv (Benefit Planners)- Michael New, Lee DeLuna, Supervisors
01.1999 - 01.2003
Claims Manager/Collections, Independent Contractor- Self Employed - Collection Solutions, Inc. - Partnership
2003 - 2005
Austin Community College - Associate Degree - Incomplete, Business Management
Texas Board of Realtors - Realtor, Real Estate
AAPC - , Medical Coding
RELEVENT WORK HISTORY
- 6/2019-6/2021 Self Employed – Investor/Contractor Rockin-R-Construction
- 4/2006-CURRENT SELF EMPLOYED – Realtor Fathom Realty Inc.
- 8/2005-3/2006 Pathology Lab Assistant Pathology Reference Lab
- 2/2003-7/2005 Self Employed Practice Mgr. Collection Solutions, Inc.
- 2/1999-2/2003 Sr. Claims Analyst Benefit Planners/Fiserv
- 1/1998-2/1999 Customer Service Rep. Texas Municipal League
- 7/1996-1/1997 Team Lead Claims Analyst USA Health Network dba Fountainhead
- 5/1992-7/1996 Medical Director Administrator Kerrville State Hospital
- 8/1991-5/1992 Clinical Director Secretary Hill Country Memorial Hospital
- 7/1982-8/1991 Support Staff Supervisor TXDOT – Lemon Law Division
SUMMARY QUALIFICATIONS
- 4 Years – Acknowledge and listen to escalated Appeals for decision to agree or overturn based on information presented. 4 Years – Attending and analyzing data provided at Clinical Quality Assurance Meetings
- 6 Years – Knowledge of CPT, ICD9 and HCPCS coding and their usage for appropriate billing.
- 6 Years – Claims and Collections; All types Medical, Hospital, Workers Comp., PIP, subrogation, Appeals. and adjustments
- 4 years – Processing claims, customer service, documentation requirements.
- 4 years – Understanding of Claims Software (FACTS) systems with ease.
- 15+years – Administrative experience for and with professionals at all levels.
- 4 Years – Supervisory and Management of support staff.
- 15+Years – Understanding of HIPAA regulations and requirements. Customer Service, expertise in listening, problems solving and referring to appropriate resources. Following HIPAA guidelines and No Surprise Act. 17+Years Sales and transaction experience