Summary
Overview
Work History
Education
Skills
Skills
Timeline
Generic

Pauline (Polly) Barlow

Long Beach,CA

Summary

Proven RCMS Specialist with a track record of enhancing client satisfaction and reducing aged accounts receivable at Veradigm. Expert in medical billing and insurance verification, combined with exceptional problem-solving abilities and customer relations skills. Achieved significant improvements in process efficiency and billing accuracy, demonstrating reliability and a strong capacity for teamwork. Once nominated for the William H and Ruth Black Employee Achievement Award for Recognition of outstanding performance at Scripps Clinic.

Overview

29
29
years of professional experience

Work History

RCMS Specialist

Veradigm (formerly CHMB and Allscripts)
10.2004 - 06.2025
  • Managed approximately 45 + accounts/claims per work day.
  • Followed all company policies and procedures to deliver quality work.
  • Improved client satisfaction rates through proactive problem-solving and efficient complaint resolution.
  • Enhanced client satisfaction with timely and accurate issue resolution.
  • Solid knowledge of medical terminology
  • Understanding of patient account maintenance/collections including resolving billing discrepancies
  • Accounts Receivable follow up and billing for all insurance policies
  • Claim corrections/Charge errors
  • Appeals and insurance verification
  • Payment posting
  • Trained offshore team
  • Trained other employees on team
  • Had one on one meetings with clients
  • Lead provider meetings
  • Charge entry
  • Work CCI edits for clearinghouse rejections.
  • Verify ERA's and EFT payments and recoupments.
  • Work credits due to insurance/patient by preparing and submitting refund requests.
  • Work closely with several different medical groups and different specialties
  • Promoted a positive work environment by actively participating in team meetings and contributing ideas for process improvements.
  • Researched billing errors and discrepancies to initiate corrective action.
  • Entered client details and notes into system for interdepartmental access and review.
  • Achieved a significant reduction in aged accounts receivable through diligent follow-up efforts with both patients and insurers.
  • Consistently meets and exceeds productivity goals.
  • Demonstrates efficiency in handling a high-volume work queue and working on the emails that I receive with tasks that need my attentions
  • Great team player

Medical Biller

Keystone Care Hospice and Palliative Care (part-time)
07.2022 - 04.2025
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
  • Verified insurance of patients to determine eligibility.
  • Reviewed patient records, identified medical codes, and created invoices for billing purposes.
  • Reviewed patient diagnosis codes to verify accuracy and completeness.
  • Audited and corrected billing and posting documents for accuracy.
  • Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
  • Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
  • Achieved significant reduction in outstanding accounts receivables by implementing rigorous follow-up procedures with insurers and patients.
  • Maintained compliance with industry regulations by staying updated on changes to medical billing codes and requirements.
  • Facilitated seamless collaboration between billing department and healthcare providers to ensure accurate billing information.
  • Ensured timely payments from insurance providers through submission of accurate and complete claims.
  • Reduced instances of denied claims, carefully reviewing and rectifying coding errors before submission.
  • Delivered timely and accurate charge submissions.

Patient Account Rep/Collector

Dermatology Associates
07.2002 - 10.2004
  • Reviewed insurance eligibility and verified coverage details to minimize claim denials and delays in payment.
  • Responded to patient and external payer inquiries.
  • Appeals
  • Medical billing and collections
  • Worked with outside entities to resolve issues with billing, claims, and payments.
  • Posted payments and processed refunds.
  • Ensured compliance with healthcare regulations while processing claims and managing patient accounts.
  • Contacted patients after insurance was calculated to obtain payments.
  • Researched billing errors and discrepancies to initiate corrective action.
  • Entered client details and notes into system for interdepartmental access and review.

Patient Account Representative

Scripps Clinic (formerly Specialty Medical Clinic)
09.1996 - 07.2002
  • Served as a reliable source of information for patients regarding appointment scheduling, insurance coverage inquiries, and general office policies.
  • Took copayments and compiled daily financial records.
  • Daily bank deposit
  • Worked closely with clinic physicians and nurses to resolve billing issues/patient scheduling
  • Collect past due balances/clear up discrepancies/process patient refunds
  • Prepare accounts for collections
  • Patient scheduling/registration of patients into computer systems
  • Verified insurance eligibility and coverage for patients.
  • Reviewed insurance eligibility and verified coverage details to minimize claim denials and delays in payment.
  • Provided exceptional customer service, handling sensitive patient situations with professionalism and empathy.
  • Managed front desk duties which included scheduling and checking in patients in a busy medical office.
  • Worked in business office in the Medicare department

Education

High School Diploma -

Lakewood High School
Lakewood, CA
06-1988

Skills

  • Customer relations
  • Team collaboration
  • Management collaboration
  • HIPAA compliance
  • Medical terminology
  • Follow-up skills
  • Payment processing
  • Data entry proficiency
  • Insurance verification
  • Medical billing
  • Insurance billing
  • Problem-solving abilities
  • Time management
  • Self motivation
  • Reliability

Skills

  • Medical billing, collection, registration, payment posting, charge entry, patient financial services, audit accounts, credits and refunds (30 + years).
  • Strong knowledge of HMO, PPO, Workers Compensation, Personal Injury, Commercial and Government insurances
  • CPT Coding
  • ICD-10
  • HIPAA
  • Allscripts Practice Management
  • EHR Systems
  • AAPC/Codify
  • Sharepoint
  • Laserfische
  • Payerpath
  • Waystar
  • Office Ally
  • Inovalon
  • EHR
  • Matrix Care
  • IDX
  • PCN



Timeline

Medical Biller

Keystone Care Hospice and Palliative Care (part-time)
07.2022 - 04.2025

RCMS Specialist

Veradigm (formerly CHMB and Allscripts)
10.2004 - 06.2025

Patient Account Rep/Collector

Dermatology Associates
07.2002 - 10.2004

Patient Account Representative

Scripps Clinic (formerly Specialty Medical Clinic)
09.1996 - 07.2002

High School Diploma -

Lakewood High School

Similar Profiles

CREATE PROFILE