Melynda Pelley
Summary
Seasoned Accounts Receivable professional with proven skills in managing reduction of AR days. Experienced with medical billing standards, state requirements and federal regulations. Researched denied claims and submitted appeals. Detailed-oriented with nine years of EPIC software experience. Skilled in working under pressure and adapting to new situations and challenges. Hardworking and dedicated to exceeding goals. Team-oriented person offering excellent communication skills.
Overview
9
9
years of professional experience
Work History
Billing Specialist
OCHIN
04.2022 - Current
- Researched and resolved billing errors to enable accurate billing in Epic.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Responded to patient and clinic concerns and questions on a daily basis.
- Located errors and promptly refiled rejected claims.
- Posted and adjusted payments from insurance companies.
Revenue Cycle Representative
MediRevv
01.2021 - 03.2022
- Checked claims for registration errors and accuracy while updating in Epic software
- Retroadjucation specialist for Express Care clinics targeting claims with oldest aging date
- Performed at high level of productivity and quality, receiving 100% quality audit scores
- Maintained productivity at higher than required, usually averaging productivity at 144%
- Work well independently and effective at multitasking
- Proficient in Microsoft Office Suite
Accounts Receivable Specialist
Providence Health & Services
06.2014 - 01.2021
- Reviewed accounts on daily basis to assess aging and pursue collection of funds for accounts receivable follow up.
- Identified, researched and resolved billing variances to maintain system accuracy and currency.
- Performed targeted collections on past due accounts aged over 90 days utilizing EPIC system
- Made outbound calls to insurance companies to resolve account needs.
- Requested proper coding be applied to claims
- Performed Charge Corrections as requested in high volumes for two years
- Retroadjudication claims specialist for Express Care clinics for regions in Oregon, Washington, Montana, Alaska, and California for one year
- Worked directly with clinics to resolve issues with specific claims
Education
Bachelor of Arts - Liberal Arts And Sciences
Eastern Oregon University
La Grande, OR06.2012
Skills
- Attention to Detail
- Federal Regulation Compliance
- Customer Relations
- Microsoft Office
- EPIC software
- Precision and Accuracy
- Proactive and Self-Motivated
- Relationship Building
- Time Management
- Departmental Collaboration
Timeline
Billing Specialist
OCHIN
04.2022 - Current
Revenue Cycle Representative
MediRevv
01.2021 - 03.2022
Accounts Receivable Specialist
Providence Health & Services
06.2014 - 01.2021
Bachelor of Arts - Liberal Arts And Sciences
Eastern Oregon University