Melissa Hill
Stansbury Park,UT
Summary
Patient Financial Services Specialist with expertise in electronic claim billing, resolving coding and charging issues, and current payer regulations. Offering 18 years of healthcare experience and the desire to learn, grow, and improve current workflows for efficiency and overall hospital success.
Overview
20
20
years of professional experience
Work History
Patient Financial Services Specialist
Yuma Regional Medical Center
01.2009 - Current
- Assist in initial training and continued mentoring of staff.
- Review claims for coding and charge errors and forward to appropriate department to resolve.
- Review payer rejections and work with coding and clinical staff to resolve.
- Research payer regulations and NUBC standards to ensure claims are billed appropriately and reduce denials.
- Maintain knowledge of current ICD-10, CPT, HCPCS, and EDI standards.
- Process late charges, credits, and coding adjustments.
- Monitor external claim errors and payer rejections for issues and patterns. Research solutions to rejections and submit requests to hospital billing analysts.
- Work with clearinghouse to resolve payer rejection issues by submitting cases via client service portal.
- Manage high-volume workloads, prioritizing tasks to ensure timely completion and quality results.
- Performs eligibility inquiries and updates accounts appropriately.
Patient Registrar/Mentor/Bed Control Coordinator
Intermountain Healthcare
12.2005 - 10.2008
- Completed patient registration for inpatient and outpatient procedures.
- Performed account maintenance to update patient demographics and insurance information.
- Answered incoming calls, collected patient co-pays, and directed patients throughout hospital.
- Maintained high standard of customer service.
- Responsible for training and mentoring of new staff as Registration Team Leader.
- Responsible for completing hospital census daily.
- Checked-in direct admit patients and completed appropriate paperwork for inpatient admission.
- Enhanced patient satisfaction with admission process through prompt and efficient bed assignment coordination
- Maintained up-to-date knowledge of bed status, ensuring accurate information was available to medical staff at all times
- Optimized hospital resources by proactively monitoring occupancy levels and adjusting bed allocations accordingly
Account Manager
Professional Management Group, Inc
03.2004 - 08.2005
- Entered patient demographics and anesthesia charges.
- Submitted insurance claims in timely manner.
- Followed up on all accounts receivable.
- Performed insurance follow-up in order to expedite claim processing.
- Responsible for writing and submitting appeal letters.
- Answered incoming calls from patients and assisted them with payment arrangements and questions regarding their accounts.
Education
Bachelor of Science - Sociology
Westminster College
Salt Lake City, UT05.2003
Skills
- Data entry expertise
- Knowledge of current ICD-10, CPT, and HCPCS codes
- Proficient in Epic, Microsoft Outlook, Microsoft Word, Microsoft Excel
- Organization and time-management
- Knowledge of current payer regulations and CMS guidelines
- Flexible and Adaptable
- Excellent work ethic
- Team Leadership
- Critical Thinking
- Training and Development
Timeline
Patient Financial Services Specialist
Yuma Regional Medical Center
01.2009 - Current
Patient Registrar/Mentor/Bed Control Coordinator
Intermountain Healthcare
12.2005 - 10.2008
Account Manager
Professional Management Group, Inc
03.2004 - 08.2005
Bachelor of Science - Sociology
Westminster College
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