Mary Trotter

Communicated with payors to follow up on outstanding underpayments, denials, and account variances.

Identified root causes of claim denials, underpayments, etc. Followed payer guidelines, state and federal regulations.

• Processed and validated patient billing information for accuracy and compliance.
• Communicated with healthcare providers to resolve billing inquiries and discrepancies.
• Assisted in preparing monthly billing reports for internal review and audit purposes.
• Utilized billing software to enter and track patient accounts efficiently.

• Managed client relationships to ensure satisfaction and retention.
• Facilitated communication between clients and internal teams for project alignment.
• Managed financial performance of assigned book of business.
• Monitored KPIs - AR. Clean Claim Rates.
• Reporting

• Prepared and sent invoices to business clients
• Managed accounts receivable, tracked payments, handled billing inquiries, and reconciled accounts to ensure accurate and timely financial transactions for business-to-business clients.
• Maintained monthly billing records
• posted payments, refunds, financial transaction for my Book of Business/Region

• Using algorithms to identify patterns, trends, and anomalies within large sets of data, regarding medical claims, to extract valuable and actionable insights.
• Resolved errored claims such as Duplicates, Retro Term, BH, SNF, Overpayments, COB through analysis of historical data.
• Reduced overpayments and Leakage by identifying incorrect payments.
• Analyzed past data to help forecast future trends and behaviors.

• Managed client accounts to ensure satisfaction and retention.
• Coordinated communication between pharmacy staff and clients for service efficiency.
• Developed personalized medication plans based on client needs and preferences.
• Trained junior staff on account management procedures and best practices.
• Call Center
• Processed clients RX orders for refill

• Assisted patients with inquiries regarding healthcare services and insurance options.
• Processed patient registrations and updated medical records efficiently.
• Coordinated communication between patients and healthcare providers effectively.
• Resolved patient complaints through active listening and problem-solving techniques.