Marie Cope
North Ogden
Summary
Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
24
24
years of professional experience
Work History
Associate Patient Care Coordinator
Optum
03.2024 - Current
- Delivered excellent patient experiences
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Organized patient records and database to facilitate information storage and retrieval from multiple EMR Systems
- prioritize member outreach based on potential gaps to improve HEDIS/Star Measures
- Followed document protocols to safeguard confidentiality of patient records.
Medical Billing Representative
Optum Primary Care Wasatch Peak
07.2022 - 03.2024
- Worked AR Reports and resolved any discrepancies in a timely manner
- Collected and processed payments from clients, and insurance companies, ensuring all transactions were recorded accurately
- Reviewed denied claims for management, highlighting any discrepancies or trends and work accounts accordingly
- Review all Coding on Medicare Wellness visits before sending out claims to ensure continued success as a 5 Star clinic
- Review billing claim forms to ensure fields are accurately populated and aligned
- Diligently filed and followed up on third party claims.
- Identify and return incomplete claim information and supporting documentation to meet payer requirements
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Comply with all government and third-party payers regulatory mandated requirements for billing, collections, and PHI
- Had to meet department productivity and quality standards in time frame given
- Worked effectively with medical payers such as Medicare, Medicaid, and commercial insurances to obtain timely and accurate payments.
- Generated monthly billing and posting reports for management review.
- Researched CPT and ICD-9/10 coding discrepancies for compliance and reimbursement accuracy.
- Actively maintained current working knowledge of CPT and ICD-9/10 coding principles, government regulation, protocols and third party requirements regarding billing.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Confidently and adeptly handled claim denials and/or appeals.
Dental Treatment Coordinator
Intermountain Dental Specialists
07.2011 - 07.2022
- Understood dental terminology and insurance breakdowns to communicate with external stakeholders.
- Communicated with insurance companies to dispute unpaid claims and verify patient coverages.
- Handled patient complaints quickly and professionally to restore patient confidence and prevent loss of clientele.
- Prepared insurance claim forms, explained benefits, and outlined pricing details for procedures and services.
Hospital Billing Specialist
Intermountain Health Care
05.2001 - 07.2011
- Performed billing and coding procedures for emergency room, impatient, and outpatient services.
- Evaluated patients' financial status and established appropriate payment plans or qualify patients for charity write-offs
- Confidently and adeptly handled claim denials and/or appeals.
- Reviewed and resolved claim issues captured in TES/CLAIMS edits and clearing house.
- Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Analyzed complex Medical Records when conducting Audits on chart reviews
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
Education
Generals -
Ogden High School
Ogden, Utah08.1996
Skills
- AR Reports
- Payment Processing
- Billing Information Management
- Customer Service
- Data Integrity
- Communication
- Medical terminology
- Production Scheduling
- Treatment Planning
- Insurance Verification
- Claim Review
- Regulatory Compliance
- Multi-line Phone Management
- Microsoft Programs
- Quick Learning
- Problem Solving
- Medical Terminology
- Workflow optimization
- Cross-functional teamwork
- Administrative supervision
- Healthcare documentation
- HIPAA protocol adherence
- Critical thinking skills
- Proficient in Microsoft applications
Accomplishments
- Microsoft Excel Intermediate course, Intermountain Health Care, 01/01/09
- Microsoft Access Intermediate course, Intermountain Health Care, 01/01/10
Timeline
Associate Patient Care Coordinator
Optum
03.2024 - Current
Medical Billing Representative
Optum Primary Care Wasatch Peak
07.2022 - 03.2024
Dental Treatment Coordinator
Intermountain Dental Specialists
07.2011 - 07.2022
Hospital Billing Specialist
Intermountain Health Care
05.2001 - 07.2011
Generals -
Ogden High School
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