Mindy Goins
White House,TN
Summary
Highly-motivated reimbursement specialist with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Functional leadership skills and a desire to take on new challenges with strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills Team oriented and results driven with focus on maintaining a positive work environment and proven ability to work with diverse populations.
Overview
13
13
years of professional experience
Work History
Billing Specialist
RenalCare 360
Franklin, TN
01.2024 - 07.2024
- Calculated billing charges, prepared and submitted claims to insurance companies.
- Performed additional duties as assigned by management team.
- Investigated incorrect billings and processed refunds as necessary.
- Verified insurance coverage and identified third-party payers for billing purposes.
- Maintained accurate records of collections, adjustments and denials in the system.
- Reviewed medical records to ensure accuracy of billing information and patient data.
- Answered customer inquiries regarding billings, payments, account status.
- Assisted in developing strategies for improving collections processes.
- Reconciled daily cash receipts with total deposits on bank statement.
- Provided support to other departments within the organization as needed.
- Processed credit card transactions through Point-of-Sale terminals or online systems.
- Worked with team members to identify and develop process improvements.
- Submitted claims to insurance companies.
- Collected, posted and managed patient account payments.
- Accurately input procedure codes, diagnosis codes and patient information into billing software to generate up-to-date invoices.
- Answered customer questions to maintain high satisfaction levels.
- Checked claims coding for accuracy with ICD-10 standards.
- Trained new team members on company policies and accounting systems to keep team operations productive and efficient.
- Reconciled codes against services rendered.
- Reviewed engine assigned codes and modifiers to update and verify accuracy.
Lead Reimbursement Specialist
Vanderbilt Medical Center
08.2013 - 12.2023
- Reviewed medical documentation to evaluate the accuracy of submitted claims for reimbursement purposes.
- Conducted financial audits of patient accounts to identify any potential overpayments or underpayments.
- Analyzed provider contracts, fee schedules, and managed care agreements to ensure compliance with reimbursement regulations.
- Coordinated with providers to resolve payment discrepancies or other billing issues.
- Identified areas where process improvements could be made to increase efficiencies in the reimbursement process.
- Developed training materials for new staff on the principles of healthcare reimbursements.
- Maintained detailed records of all reimbursements including payments, denials, appeals, and adjustments.
- Responded promptly to inquiries from internal staff members regarding reimbursement policies and procedures.
- Performed root cause analysis when investigating payment denials or delays.
- Generated monthly reports for management summarizing key performance metrics related to reimbursements.
- Provided guidance and assistance to other departments in understanding the complexities of healthcare reimbursement systems.
- Obtained maximum reimbursement by following up on unpaid claims and reviewing monthly aging reports.
- Reviewed uninsured accounts, verifying medical assistance application process, charity care application and drug replacement program availability.
- Determined medical necessity, using individual insurance carrier regulations.
- Identified opportunities for coverage access to address reimbursement barriers.
- Maintained confidentiality and integrity of patient data.
- Verified technical reimbursement questions for providers, billing and coding staff.
- Researched rejections, investigating problems to appeal claims.
- Drafted documents based on payer guidelines and submitted to necessary parties.
- Verified clients' insurance claims coverage by coordinating with providers.
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
- Collaborated with fellow team members to manage large volume of claims.
- Prepared and reviewed insurance-claim forms and related documents for completeness.
- Organized information by using spreadsheets, databases or word processing applications.
- Transcribed data to worksheets and entered data into computer to prepare documents and adjust accounts.
Biller
Volunteer Behavioral Health Care Services
12.2011 - 08.2013
- Researched and resolved discrepancies in patient accounts, insurance claims, and billing records.
- Processed appeals for denied insurance claims ensuring timely reimbursement from third-party payers.
- Adhered to HIPAA guidelines regarding confidentiality of patient data at all times.
- Verified accuracy of patient data including demographics, payer information, and coding.
- Reconciled payments received against outstanding balances due from insurers.
- Submitted electronic claims as well as paper claim forms via mail or fax according to regulations.
- Implemented changes in system parameters when needed based on changes in contracts and policies.
- Reviewed Explanation of Benefits statements received from insurers for accuracy and completeness.
- Managed follow up on unpaid or rejected claims; contacted insurers as necessary for resolution.
- Provided customer service support regarding insurance coverage questions or concerns.
- Collaborated with medical staff to ensure accurate coding of services rendered to patients.
- Collaborated with fellow team members to manage large volume of claims.
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
Education
Business
Beech High School
Hendersonville, TN01.1982
Skills
- Coverage determination
- 10-key touch
- Composing business correspondence
- Customer service
- Problem solving
- Financial transactions
- Payment investigation and escalation
- Policy review
- Decision making
- Time management
- Claim corrections
- Payment posting
- Payer escalations
- Teamwork and collaboration
- Critical thinking
- Insurance claims
- Eligibility verification and determination
- Excel data mining
- Billing dispute resolution
- Research and due diligence
- Medical billing and collections
- HIPAA Compliance
- Insurance Verification
- Accounting Support
- Quality Control
- Professional Demeanor
- Active Listening
- Presentation Skills
- Team building
- Effective Communication
- Interpersonal Skills
- Decision-Making
- Time management abilities
- Reliability
- Teamwork and Collaboration
- Organizational Skills
- Problem-solving abilities
- Multitasking
- Database Management
- Account Reconciliation
- Customer Account Management
- Customer Service
- Bank Statement Reconciliation
- Administrative Support
- Discrepancy Resolution
- Inquiry Handling
- Payment Processing
- Customer Engagement
- Account updating
- Correspondence Preparation
- Procedure Development
Leadership Experience
- Obtained maximum reimbursement by following up on unpaid claims and reviewing monthly aging reports.
- Organize information using spreadsheets, databases, or word processing applications.
- Investigated billing discrepancies and implemented effective solutions to resolve concerns and prevent future problems.
- Assisted in streamlining accounts receivable process by identifying areas for performance improvement.
- Trained team members on company policies and accounting systems to keep team operations productive and efficient.
References
Available upon request.
Timeline
Billing Specialist
RenalCare 360
01.2024 - 07.2024
Lead Reimbursement Specialist
Vanderbilt Medical Center
08.2013 - 12.2023
Biller
Volunteer Behavioral Health Care Services
12.2011 - 08.2013
Business
Beech High School
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