MICHELLE SCOTT
Warrenton,VA
Summary
Experienced RCM AR Representative highly skilled in procedure optimization and revenue metrics analysis to increase financial performance. Well-versed in billing cycle operations and the execution of the processes that drive revenue cycle performance. Ability to quickly adjust to changing workflows. Excellent reputation for the ability to apply advanced skills to resolve complex problems independently. Highly motivated to learn, grow, and excel in all areas within the revenue cycle. Encouraging team member and analytical problem-solver with talents for team building, leading and motivating, as well as excellent customer relations aptitude and relationship-building skills. Proficient in using independent decision-making skills and sound judgment to positively impact company success. Promoted a positive organizational culture by exemplifying company values and fostering a strong sense of teamwork among colleagues.
Overview
27
27
years of professional experience
Work History
RCM AR Representative Remote
Medvanta
06.2025 - Current
- Manages the financial follow-up for healthcare providers by tracking unpaid or denied medical claims
- Communicating with insurance payers, and ensuring timely reimbursement.
- Investigate claim denials, file appeals, and reduce aging accounts to ensure uninterrupted cash flow.
- Exceeded performance targets through diligent work ethic and focus on results-driven tasks.
- Updated job knowledge by participating in educational opportunities, reading professional publications, and maintaining personal networks.
- Same skills as the job below.
RCM AR Representative - Fully Remote
Allscripts/Veradigm
07.2022 - 06.2025
- Access payer websites and discern pertinent data to resolve accounts
- Document clear and concise notes in the patient accounting system regarding claim status and any actions taken on an account
- Maintain department daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadership
- Identify and communicate any issues including system access, payor behavior, account work-flow inconsistencies or any other insurance collection opportunities
- Denial Management – Research and determine claim denials and take appropriate action for payment within federal, state, and payor guidelines.
- Trend Identification – Identify consistent payor or system trends that result in underpayments, denials, errors, etc.
- Payor Escalation – Ability to understand and navigate payor guidelines. Determine and escalate claim issues with payor when appropriate.
- Trend Escalation – Meet with leadership to discuss/resolve reimbursement and/or payor obstacles.
- Appeals – Determine when an appeal, reopening, redetermination, etc. should be requested and the requirement of each insurance carrier. Take appropriate action to resolve claim.
- Claim Status – Use available resources such as payor portals and clearinghouses to review unresolved accounts.
- Unapplied Payments – Identify unapplied payments and take appropriate action to resolve account.
Revenue Cycle Representative - Fully Remote
MediRevv, a Tegria Company
01.2022 - 07.2022
- Resolve payer rejections and denials through the appeals process as required by each payer.
- Follow up with insurance companies regarding the status of outstanding claims and necessary steps for resolution.
- Answer and review pertinent insurance correspondence to insure complete and accurate reimbursement for medical claims
- Responsible for working payer correspondence edits and aged account receivable and identifying and correcting billing errors.
- Research payer rules and regulations to maintain current payer knowledge.
- Compose correspondence including claim forms, appeals, and notifications to applicable parties.
- Contact and educate patients and guarantors regarding necessary steps to resolve an outstanding insurance balance while providing exemplary customer service.
- Complies with HIPAA and other compliance requirements to protect patient confidentiality.
Regional Training Coordinator
PT Solutions
01.2017 - 01.2022
- Assisted with startup of 12 outpatient PT clinics in the Northern Virginia Area.
- Created and implementing training programs to improve the effectiveness of the clinics and overall operation of the organization.
- Developed departmental systems and procedures to better align revenue cycle workflow processes
- Responsible for ensuring compliance with established practice policies and procedures, state, and federal healthcare standard
- Communicated professionally with colleagues, patients, insurance representatives, physicians, and clients.
- Facilitated onboarding sessions for new hires, ensuring smooth integration into company culture.
- Collaborated with management to assess training needs and implement effective solutions.
- Promoted a positive organizational culture by exemplifying company values and fostering a strong sense of teamwork among colleagues.
Revenue Cycle Manager
Blaser Physical Therapy
01.2011 - 01.2017
- Assessed current revenue cycle procedures and implemented improvements to foster efficiency.
- Analyzed financial reports to identify trends and improve revenue forecasting accuracy. Tracking Key Performance Indicators (KPIs)
- Streamlined revenue cycle processes to enhance billing accuracy and reduce claim denials.
- Established relationships with payers to ensure timely resolution of billing inquiries and disputes.
- Reduced days in accounts receivable by implementing more efficient follow-up procedures with payers.
Physical Therapy Aide/Data Entry/Billing Support
Blaser Physical Therapy
01.2009 - 01.2011
- Assist therapists in restorative and rehabilitative treatments.
- Assisted front desk by answering phones, scheduling appointments, filing documents, processing payments, coding, billing process.
Professional Fire Fighter/EMT
Prince William, Fire and Rescue
01.1999 - 01.2007
- The job of fire fighter involves the protection of life and property by combating, extinguishing, and preventing fires.
- Work involves training for and participating in firefighting duties, providing emergency care for sick and injured persons and fire prevention activities on assigned shifts.
Education
Some College (No Degree) - Health And Human Development
Penn State University
State College, PAHealth And Human Development
University of Hawaii At Manoa
Honolulu, HIHigh School Diploma - undefined
Admiral Arthur W Radford High School
Honolulu, HI01.1993
Skills
- Superior decision making, analytical and critical thinking, and conflict resolution skills with the ability to identify issues and trends
- Knowledge of medical terminology, CPT codes, modifiers and diagnosis coding, HIPAA and healthcare compliance standards
- Comprehensive understanding of the Revenue Cycle as it relates to the entire life of a patient account from creation (registration, authorizations, insurance verification) to payment (billing, follow-up, denials and rejections, insurance appeals)
- Ability to use various billing and patient information computer systems (EPIC, Practice Management) for HB (Hospital Billing) and PB (Professional Billing)
- Intermediate skills in Microsoft Office (Outlook, Excel, Word, PowerPoint)
Timeline
RCM AR Representative Remote
Medvanta
06.2025 - Current
RCM AR Representative - Fully Remote
Allscripts/Veradigm
07.2022 - 06.2025
Revenue Cycle Representative - Fully Remote
MediRevv, a Tegria Company
01.2022 - 07.2022
Regional Training Coordinator
PT Solutions
01.2017 - 01.2022
Revenue Cycle Manager
Blaser Physical Therapy
01.2011 - 01.2017
Physical Therapy Aide/Data Entry/Billing Support
Blaser Physical Therapy
01.2009 - 01.2011
Professional Fire Fighter/EMT
Prince William, Fire and Rescue
01.1999 - 01.2007
High School Diploma - undefined
Admiral Arthur W Radford High School
Some College (No Degree) - Health And Human Development
Penn State University
Health And Human Development
University of Hawaii At Manoa