MaryLynn Pearce CPC

Revenue Cycle Expert

NSN Revenue Resources/United Surgical Partners

04.2014 - Current

Increased revenue by identifying and resolving billing errors in a timely manner.
Enhanced customer satisfaction by promptly addressing and resolving billing disputes.
Ensured accurate billing with thorough audits of patient accounts and insurance claims.
Reached out to insurance companies to verify coverage.
Contacted responsible parties for past due debts.
Achieved optimal reimbursement rates by verifying insurance coverage, eligibility, benefits, and authorization prior to service delivery.
Streamlined the revenue cycle process for improved efficiency and faster payment collection.
Coordinated patient payment plans, balancing compassion with firmness to ensure timely payments while preserving positive patient relationships.
Identified and resolved payment issues between patients and providers.
Assisted patients in understanding complex billing statements, leading to increased trust between patients and healthcare providers.
Maintained clear documentation of all activities related to unpaid claims or denied services.
Maximized reimbursements by staying current on payer requirements and maintaining strong relationships with insurance providers.
Improved cash flow with diligent follow-up on pending claims and appeals processes.
Optimized revenue cycle, implementing effective strategies for claims management and reimbursement.
Played key role in transition to new billing system, ensuring smooth conversion with minimal disruption to operations.
Successfully navigated complex insurance disputes, resulting in recovery of substantial amounts of previously denied claims.
Enhanced revenue collection efficiency with robust follow-up procedures on delinquent accounts.
Conducted detailed analyses of revenue cycle metrics, identifying trends and developing action plans to address areas of concern.
Timely follow-up and resolution on all outstanding A/R including unpaid/underpaid/denied claims for all payers including self-pay to obtain maximum reimbursement
Send appeals when appropriate or provide medical documentation to resolve unpaid claims
Review Insurance payments and determine accuracy of reimbursement based on contracts, fee schedules, and summary plan documents
Take incoming patient phone calls to resolve inquiries, billing issues, or outstanding balances
Negotiate payment amounts for procedures with Third Party Administrators for out of network providers