MELISSA CROWE
London,KY
Summary
Account Revenue Specialist, CRCR Certified with over 13 years of experience in healthcare revenue cycle management. Adept at analyzing payment variances, streamlining claim resolution processes, and leading teams to enhance efficiency and patient care coordination. Proven track record in achieving timely reimbursements and improving operational efficiency through strategic interventions and cross-functional collaboration. Possesses versatile skills in project management, problem-solving, and collaboration. Brings fresh perspective and strong commitment to quality and success. Recognized for adaptability and proactive approach in delivering effective solutions.
Overview
14
14
years of professional experience
Work History
Account Revenue Specialist, CRCR Certified
Ensemble Health
04.2024 - Current
- Resolve claim payment issues with commercial and governmental payers for timely reimbursement
- Analyze denials and payment variances, draft and submit technical and clinical appeals
- Maintain compliance with federal and state regulations, ensuring accurate documentation
- Identify root causes of payment delays, communicate trends and issues to management
- Meet productivity and quality standards, demonstrating initiative and resourcefulness
- Streamline claim resolution processes, achieving 95% timely reimbursement by identifying and addressing payment variances efficiently
- Analyze denials and payment discrepancies, improving claim resolution rates by 20% through detailed root cause analysis and strategic interventions
- Coordinate with payers and internal teams to resolve outstanding claims, enhancing cross-functional communication and achieving faster payment cycles.
Medical Support Assistant-HAS
Department of Veterans Affairs
02.2013 - 03.2020
- Scheduled and verified provider orders, ensuring compliance with VHA guidelines, enhancing appointment accuracy
- Led a team of 150-300 employees, improving team efficiency and patient care coordination
- Processed emergency and non-emergency transfers, ensuring timely and appropriate patient care transitions
- Trained new employees, fostering a knowledgeable and effective workforce
- Monitored inpatient and outpatient appointments, ensuring timely completion and workload credit
- Led a team of 150-300 employees, optimizing scheduling and resource allocation, resulting in a 20% increase in operational efficiency
- Implemented and monitored electronic wait lists, ensuring minimal patient wait times and improving clinic throughput by 15%.
Billing Clerk
Children's Clinic
07.2012 - 02.2013
- Handled billing insurance and posting payments, ensuring accurate and timely processing
- Managed patient billing and insurance claims, ensuring compliance with medical coding standards and reducing billing errors by 15%
- Coordinated with medical staff to verify accurate progress notes and code entries, improving the clinic's documentation process
- Handled multi-line phone systems and managed patient records, ensuring efficient data entry
- Verified insurance details and processed referrals, enhancing patient access and satisfaction
- Collected payments, scheduled appointments, and maintained inventory, supporting clinic operations
- Streamlined patient check-in processes, enhancing efficiency by 20%, ensuring accurate insurance verification, and optimizing appointment scheduling
- Led efforts in maintaining accurate medical records and demographic data entry, contributing to a 15% reduction in administrative errors.
Patient Access Representative
Baptist Express Care Clinic
01.2011 - 08.2012
- Handled billing insurance and posting payments, ensuring accurate and timely processing
- Managed patient billing and insurance claims, ensuring compliance with medical coding standards and reducing billing errors by 15%
- Coordinated with medical staff to verify accurate progress notes and code entries, improving the clinic's documentation process
- Handled multi-line phone systems and managed patient records, ensuring efficient data entry
- Verified insurance details and processed referrals, enhancing patient access and satisfaction
- Collected payments, scheduled appointments, and maintained inventory, supporting clinic operations
- Streamlined patient check-in processes, enhancing efficiency by 20%, ensuring accurate insurance verification, and optimizing appointment scheduling
- Led efforts in maintaining accurate medical records and demographic data entry, contributing to a 15% reduction in administrative errors.
Education
No Degree - Billing And Coding
Ultimate Medical Academy - Clearwater
Clearwater, FL01.2025
High School Diploma -
Southwestern High School
Somerset, United States05.1998
Skills
- Billing
- Coding
- Scheduling
- Data Entry
- Customer Service
- Team Lead
- Training
- Project Management
- Microsoft Office
- Epic
- Workday
- EIQ
- Meditech
- WPS
- Inovalon
- SSI
- DDE
- Invoice Processing
- Microsoft Excel expertise
- Payment Processing
- Auditing procedures
- Collections Management
- Interpersonal communication skills
- Data entry skills
- Teamwork and Collaboration
- Problem-Solving
- Time Management
- Recordkeeping and documentation
- Multitasking
- Leadership skills
- Excellent Communication
- Organizational Skills
- Attention to Detail
- Adaptability and Flexibility
- Microsoft Office proficiency
- Self Motivation
- Strategic Thinking
- Time management abilities
- Decision-Making
- Team Collaboration
- Effective Communication
- Critical Thinking
- Active Listening
- Reliability
- Adaptability
- Professionalism
- Interpersonal Skills
- Team building
- Analytical Thinking
- Task Prioritization
- Decision-making skills
- Written Communication
- Goal Setting
- Teamwork skills
- Account Reconciliation
- Regulatory Compliance
- Professional Demeanor
- Research proficiency
References
- Jennifer Dubois, (235)4334892
- Rayn Pribula, (606)219-7676
Affiliations
- Department of Veterans Affair Homeless Veterans Program
Timeline
Account Revenue Specialist, CRCR Certified
Ensemble Health
04.2024 - Current
Medical Support Assistant-HAS
Department of Veterans Affairs
02.2013 - 03.2020
Billing Clerk
Children's Clinic
07.2012 - 02.2013
Patient Access Representative
Baptist Express Care Clinic
01.2011 - 08.2012
No Degree - Billing And Coding
Ultimate Medical Academy - Clearwater
High School Diploma -
Southwestern High School