Michelle Bercey
Naples,FL
Summary
At Ensemble Hp, I spearheaded the enhancement of reimbursement processes, notably boosting financial performance through strategic improvements. My expertise in healthcare reimbursement and exceptional problem-solving skills led to significant advancements in claims processing efficiency and patient satisfaction. My role as a subject matter expert underscored my adaptability and deep understanding of complex payer systems. I have obtained my CRCR certification The CRCR certification provides a deeper understanding of the entire strategies and identify key performance metrics . This certification assisted in my goal to increase receivables, reduce denials, and work more efficiently in the revenue cycle role.
Overview
24
24
years of professional experience
1
1
Certification
Work History
SR AR Reimbursement
Ensemble Hp
03.2001 - Current
- Developed training materials for new hires, expediting the onboarding process for Reimbursement Analysts in a fast-paced environment.
- Collaborated with healthcare providers to ensure accurate billing information for prompt reimbursements.
- Boosted financial performance by identifying trends and recommending improvements to reimbursement procedures.
- Increased patient satisfaction with clear explanations of benefits, coverage limits, and out-of-pocket expenses related to their treatments.
- Served as a subject matter expert on specific payers or types of claims, contributing specialized knowledge during internal meetings or presentations aimed at improving overall team effectiveness in handling reimbursement matters.
- Enhanced revenue recovery with diligent monitoring of outstanding payments and submission of appeals.
- Improved reimbursement processes by analyzing and resolving payment discrepancies.
- Maintained a detailed understanding of the organization''s payer mix and reimbursement rates, providing key insights during budget planning or forecasting discussions.
- Ensured compliance with government regulations through thorough documentation review and adherence to established protocols.
- Maintained updated knowledge on insurance policies, coding guidelines, and industry regulations to maximize reimbursement potential.
- Streamlined claims processing for increased efficiency and accuracy in reimbursements.
- Provided exceptional customer service, assisting patients with inquiries related to their insurance coverage and reimbursement status.
- Assisted in contract negotiations, providing valuable insights into market trends and competitive pricing structures.
- Supported team members by sharing expertise in reimbursement methodologies and payer contracts analysis.
- Followed up on denied and unpaid claims to resolve problems and obtain payments.
- Coordinated with insurance providers to verify customer's policy benefits in relation to claims.
- Delivered timely information to insurance representatives to resolve common and complex issues.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Calculated adjustments, premiums and refunds.
- Coordinated with contracting department to resolve payer issues.
Education
General Studies
Broward Community College
Hollywood FloridaSkills
- Appeals handling
- HIPAA compliance
- Healthcare reimbursement
- Claims processing
- Insurance verification
- Denial management
- Revenue cycle management
- Eligibility verification
- Commercial insurance
- Teamwork and collaboration
- Customer service
- Time management
- Problem-solving
- Attention to detail
- Multitasking
- Claims investigation
Certification
CRCR
Languages
Spanish
Professional Working
Timeline
SR AR Reimbursement
Ensemble Hp
03.2001 - Current
General Studies
Broward Community College
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