Marguerite Fitzpatrick, RHIT, CPC
League City,TX
Summary
Seasoned Billing/Coding Insurance Specialist with excellent planning and problem solving abilities. Offering education, experience and confidence to take on any challenge. Organized, driven and adaptable professional with successful history managing multiple location revenue accounts in fast paced environments. Displaying excellent planning and problem solving abilities. Insurance professional offering 17+ years of experience in Health Information Management working with all Major Medical insurance plans.
Overview
16
16
years of professional experience
Work History
Insurance Administrator
Texas State Optical
Galveston, TX
05.2008 - Current
- Analyzed financial reports for potential revenue improvement initiatives.
- Monitored performance metrics related to accounts receivable aging, denials, rejections.
- Assisted with preparation of monthly financial statements including balance sheets, income statements.
- Investigated unpaid claims and identified causes of delays or denials in payment processing.
- Consulted with other departments within the organization regarding billing processes.
- Prepared monthly reports summarizing key performance indicators related to collections activities.
- Responded promptly to patient inquiries concerning their account status or billing questions. Resolving all inquiries and complaints requiring management-level escalation.
- Educated providers how to properly code for maximum reimbursement.
- Managed A/R outstanding balances and denied claims.
- Resolved billing issues utilizing my education and experience, completing in-depth research.
- Worked with several EHR's to manage patient records and financial accounts.
- Provided leadership, mentoring newly hired employees, training new staff with knowledge of organization's billing policies and procedures.
- Produced thorough, accurate and timely reports of projects, meeting all deadlines
- Implemented protocol to improve efficient and effectiveness to areas of identified weakness.
- Implemented and maintained electronic billing software.
- Conducted insurance verification, pre-authorization, coded procedures and managed patient charts.
- Enforced operational compliance with state and federal laws and reimbursement standards.
- Monitored all staff are following HIPAA guidelines.
- Provided administrative support to all staff
- Prepared correspondence including letters of referral or authorization requests to insurance companies.
- Electronically billed major medical and vision plans to ensure timely reimbursement of services rendered.
- Maintained up-to-date knowledge of applicable laws and regulations governing health care reimbursement.
- Resolved complex payment discrepancies between providers, patients, and payers.
- Performed detailed analysis of accounts receivable data to identify trends in billing issues.
- Conducted periodic audits of patient records to verify coding accuracy and completeness of documentation.
- Provided consulting services to clients in the areas of operations, finance, marketing, billing and strategy development.
- Developed improved standard operating procedures to increase billing/payment accuracy.
- Updated internal databases with current information on products, pricing, and services offered.
- Prepared financial reports related to premium payments, claim settlements, and other administrative activities.
- Organized information by using spreadsheets, databases or word processing applications.
- Retained strong medical terminology understanding in effort to better comprehend procedures.
Education
Medical Coding Certification - Medical Insurance Coding
College of The Mainland
Texas City, TX05.2007
Associate of Applied Science - Health Information Technology
College of The Mainland
Texas City, TX05.2007
Skills
- Medical/Vision insurance Billing and Coding
- Insurance payment posting
- Accounts Payable and Receivable
- 17 Years experience with electronic billing software
- Provider Insurance Credentialing
- Claims Processing
- Data Entry
- Customer Service
- Teamwork and Collaboration
- Eligibility Determination
- Insurance Claim Forms Review
- Data Entry Software
- Insurance terminology
- Medical Terminology
- Exceptional recordkeeping abilities
- Insurance plan verification
- Records Management
- Microsoft Office
- Problem-solving abilities
- Critical Thinking
- Workflow Planning
- Data Analysis
- Collections strategies
- Training and Mentoring
References
References available upon request.
Timeline
Insurance Administrator
Texas State Optical
05.2008 - Current
Medical Coding Certification - Medical Insurance Coding
College of The Mainland
Associate of Applied Science - Health Information Technology
College of The Mainland