Renae Zaeska
Atwater,Minnesota
Summary
Detail-oriented Revenue Cycle Specialist with extensive expertise in revenue cycle management, including prior authorizations, medical billing, and claims processing. Recognized for enhancing workflow efficiency and ensuring compliance with regulations while delivering high-quality patient service and accurate reimbursement outcomes.
Overview
1
1
Certification
15
15
years of professional experience
Work History
Revenue Cycle Specialist
Optum Health
01.2023 - Current
- Manage the full revenue cycle process, including insurance authorizations, eligibility verification, claims submission, reimbursement follow-up, and denial resolution.
- Reviewed and submitted clinical documentation to ensure medical necessity and facilitate timely prior authorization approvals.
- Collaborate with providers, clinical staff, insurance companies, and patients to ensure timely approvals and accurate claim processing.
- Maintained accurate patient accounts and documentation in Epic and other electronic health record systems to support efficient revenue cycle management.
- Ensure compliance with payer guidelines, HIPAA regulations, and organizational policies.
- Identified and implemented workflow improvements that enhanced reimbursement outcomes and increased patient satisfaction.
- UnitedHealthcare
Prior Authorization Specialist
Meeker Memorial Hospital
10.2018 - 01.2023
- Secured prior authorizations for diagnostic testing and medical procedures, facilitating timely patient care.
- Reviewed physician documentation to confirm medical necessity and compliance with payer requirements, ensuring authorization success.
- Communicated with providers, patients, and insurance companies to obtain required clinical information.
- Monitored authorization requests to achieve timely approvals, reducing potential treatment delays.
- Maintained detailed documentation and efficiently resolved authorization-related issues.
Paraprofessional
ACGC High School
09.2014 - 05.2018
- Supported teachers in delivering classroom instruction and providing tailored student assistance to enhance learning outcomes.
- Guided students in comprehending assignments, completing coursework, and preparing for assessments to foster academic achievement.
- Assisted teachers with classroom instruction and individualized student support.
- Partnered with teachers and administrators to advance student success and cultivate a positive learning environment.
Coding Specialist
Admin Connections
10.2011 - 07.2014
- Collaborated with physicians and clinical staff to ensure accurate documentation and coding compliance.
- Processed Medicare billing and electronic claims submissions to ensure timely reimbursement.
- Researched coding guidelines and resolved billing discrepancies.
- Researched coding guidelines and resolved billing discrepancies to maintain compliance and accuracy.
- Acted as a coding resource for physicians and fellow team members while supporting revenue integrity.
Education
Associate of Science -
Ridgewater College
Willmar, MinnesotaCertificate -
Rasmussen College
St. Cloud, MinnesotaSkills
- Revenue Cycle Management
- Claims Processing & Reimbursement
- Denial Resolution
- Prior Authorizations
- Claims processing
- Clinical Documentation Review
- CPT, ICD-10 & HCPCS Coding
- Medical Billing & Coding
- EMR systems
- Medical Coding
- Denial Management
- Medical coding
- Multiple EMR/EHR Systems
- Patient Interaction
- Cross-Functional Collaboration
- Data Analysis Tools
- Microsoft Office Suite
- Microsoft PowerPoint
- Data Entry
- Attention to Detail
- Time Management
- Problem Solving
- Customer Service
- Workflow Optimization
- Detail orientation
- Problem Solving
Certification
- Certified Coding Specialist (CCS)
- Epic Certified
- CPR Certified
Personal Information
Title: Revenue Cycle Specialist
Key Qualifications
- Revenue Cycle Management
- Prior Authorizations
- Insurance Verification
- Medical Billing & Coding
- Claims Processing & Reimbursement
- Denial Resolution
- Clinical Documentation Review
- Epic Electronic Health Record (EHR)
- Multiple EMR/EHR Systems
- Medicare & Commercial Insurance
- HIPAA Compliance
- CPT, ICD-10 & HCPCS Coding
- Process Improvement
- Customer Service Excellence
- Team Collaboration
- Microsoft Office Suite
Timeline
Revenue Cycle Specialist
Optum Health
01.2023 - Current
Prior Authorization Specialist
Meeker Memorial Hospital
10.2018 - 01.2023
Paraprofessional
ACGC High School
09.2014 - 05.2018
Coding Specialist
Admin Connections
10.2011 - 07.2014
Associate of Science -
Ridgewater College
Certificate -
Rasmussen College