EPIC
RoseMarie Werner
Reimbursement Specialist, Revenue cycle& Financial Counselor
Highland,IN
Work Preference
Summary
Professional with strong background in financial counseling, reimbursement processes, and patient interactions. Demonstrated ability to navigate complex billing systems and insurance protocols, ensuring clear communication and resolution of financial matters. Known for strong collaboration skills and adaptable approach to changing needs, consistently achieving results. Skilled in financial analysis, patient advocacy, and effective problem-solving, highly valued by employers.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Patient Financial Counselor I / Reimbursement Specialist
Northwest Cancer Centers
04.2022 - Current
- Reimbursement Optimization: Secured $500K+ in annual pharmaceutical assistance, directly reducing patient out-of-pocket liability while strengthening the organization's revenue cycle and recovery.
- Payer Navigation: Maintain expert-level knowledge of Medicare, Medicaid, and commercial reimbursement policies to ensure accurate billing and reduce discrepancies.
- Account Resolution: Establish and monitor structured payment arrangements and financial assistance applications with 99% accuracy, supporting consistent on-time payments and cash flow.
- Clinical Collaboration: Partner with clinical and business office staff to review authorizations and coding for E&M services, ensuring all services meet payer-specific reimbursement criteria.
- Workflow Efficiency: Streamlined financial workflows and patient referrals to community resources, improving office efficiency by ~10%.
- Enhanced patient understanding and reduced financial stress with clear explanations of complex insurance benefits and coverage.
- Educated patients on available financial assistance programs, increasing their access to necessary healthcare services.
- Increased patient confidence in the billing process by providing clear explanations of insurance benefits and coverage limitations.
- Conducted thorough audits of patient accounts to identify discrepancies and prevent potential revenue loss.
Office Manager
St. Paul's Lutheran Church
08.2021 - 04.2022
- Operations Leadership: Supervised office staff and volunteers, managing daily operations and administrative workflows.
- Financial Administration: Directed payroll and HR processes with a 100% on-time completion record.
- Conducted regular inventory assessments of office supplies, ordering necessary items proactively to prevent stock shortages.
- Handled sensitive information with discretion, maintaining confidentiality of company documents and personnel records.
- Coordinated office events and meetings, ensuring timely execution and optimal scheduling for all participants.
Office Administrator
Helix Surgicenter
06.2020 - 07.2021
- Billing Integrity: Verified insurance coverage and authorizations for all surgical cases, ensuring a 95%+ clean claim rate.
- Payment Reconciliation: Posted electronic and manual payments, including deductibles and coinsurance, ensuring zero discrepancies in financial reporting.
- Coordinated communications, financial processing, registration, recordkeeping, and other administrative functions.
- Maintained electronic and paper filing systems for easy retrieval of information.
- Maximized office space utilization by maintaining a clean, organized work environment that encouraged productivity and efficiency.
Payment Poster / Business Office
Orthopedic Specialists of Northwest Indiana
04.2018 - 06.2020
- A/R Management: Processed $100k+ in monthly payments and reduced Days in A/R by identifying and escalating denial patterns for immediate follow-up.
- Maintained compliance with HIPAA regulations while handling sensitive patient information during payment posting tasks.
- Identified overpayments and processed refunds for insurance carriers and patients.
- Increased accuracy of patient account balances by diligently applying payments according to insurance guidelines.
- Contributed to the reduction of aged accounts receivable by prioritizing oldest outstanding balances for follow-up action.
- Enhanced payment processing efficiency by implementing a streamlined posting system.
Patient Services Representative
Franciscan Physician Network
10.2015 - 04.2018
- Front-End Revenue: Managed registration and point-of-service collections while securing prior authorizations for high-volume outpatient clinics.
- Served as a reliable source of information for patients regarding appointment scheduling, insurance coverage inquiries, and general office policies.
- Actively participated in team meetings focused on improving workflows and enhancing overall practice performance.
- Managed patient registration process, confirming data accuracy and completeness.
- Balanced deposits and credit card payments each day.
- Participated in ongoing training programs related to HIPAA compliance, maintaining up-to-date knowledge on regulatory requirements.
Education
Associate of Science - Healthcare
Ivy Tech Community College of Indiana
Indianapolis, IN05-2015
Skills
- Denial Management
- Payment Resolution
- Claims Review
- Medicare/Medicaid Guidelines
- Prior Authorizations
- Benefits Verification
- EHR (EPIC)
- Patient Counseling
- Account Reconciliation
- PAPs
- CPT, HCPCS, ICD-10
- HIPAA Regulations
- Payroll/HR
- Workflow Optimization
- Staff Supervision
Certification
- CPC
- CPB
Personal Information
Title: Reimbursement Specialist | CPC, CPB | Revenue Cycle & Patient Financial Counseling
Certifications And Technical Skills
Certified Professional Coder (CPC), Certified Professional Biller (CPB) - AAPC, EPIC, EMR/EHR Systems, Microsoft Office Suite (Expert Excel/Word), Navinet, Availity, Claim Scrubbers, Payment Posting Portals
Accomplishments
- Achieved approvals by completing applications with 99% accuracy and efficiency.
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Affiliations
- AAPC
Quote
You will recognize your own path when you come upon it because you will suddenly have all the energy and imagination you will ever need.
Sara Teasdale
Software
Microsoft Suite
EMR/EHR
Languages
English
Full Professional
Interests
I am interested in patient advocacy, and healthcare finance
Timeline
Patient Financial Counselor I / Reimbursement Specialist
Northwest Cancer Centers
04.2022 - Current
Office Manager
St. Paul's Lutheran Church
08.2021 - 04.2022
Office Administrator
Helix Surgicenter
06.2020 - 07.2021
Payment Poster / Business Office
Orthopedic Specialists of Northwest Indiana
04.2018 - 06.2020
Patient Services Representative
Franciscan Physician Network
10.2015 - 04.2018
Associate of Science - Healthcare
Ivy Tech Community College of Indiana