Suzanne Meisterhans
INDIANAPOLIS,IN
Summary
Highly-motivated employee 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.
Overview
13
13
years of professional experience
Work History
Denial Specialist
Hopebridge Autism Therapy Centers LLC
Indianapolis, IN
05.2022 - Current
- Identified any discrepancies in patient information, provider information, or coding accuracy as part of the denial process.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Analyzed and interpreted policy language, medical records, and other relevant data to identify coverage issues.
- Monitored assigned accounts for payment resolution or appeal opportunities.
- Reviewed and evaluated claims to determine if they meet the insurance criteria for reimbursement.
- Investigated and documented payment errors resulting from incorrect processing of claims.
- Maintained communication with providers regarding denied claims and appeals processes.
Precertification Specialist
Hopebridge Autism Therapy Centers LLC
Indianapolis, IN
03.2023 - Current
- Reviewed patient medical records to determine medical necessity for requested services and procedures.
- Compiled and submitted precertification requests for review by payers in accordance with established timelines.
- Provided follow-up on pending precertification requests to ensure timely processing.
- Compiled and coded patient information or data in appropriate computer system.
- Resolved any discrepancies identified during the precertification process.
- Developed and maintained relationships with payer contacts to resolve complex issues quickly.
- Explained eligibility details and affordability options to patients with kindness and respect.
- Participated in new hire training and development tasks.
- Verified insurance eligibility, coverage levels, and benefit parameters prior to submission of precertification requests.
Precertification Specialist
APCM
Carmel, IN
03.2018 - 04.2022
- Entered client information and files into databases for further review and tracking.
- Responded to client inquiries and concerns and escalated complex problems to department supervisors.
- Resolved any discrepancies identified during the precertification process.
- Interviewed patients to complete case histories and intake forms.
- Attended meetings with providers regarding their utilization management needs.
- Identified opportunities for improvement within the precertification process and recommended solutions accordingly.
Denial Specialist/Precertification Specialist
Northside ENT
Carmel, IN
11.2010 - 01.2017
- Collected payments, processed receipts and informed policyholders of outstanding balances.
- Assisted claimants, providers and clients with problems or questions regarding claims.
- Coordinated and planned investigations of claims to confirm compensability and coverage.
- Identified any discrepancies in patient information, provider information, or coding accuracy as part of the denial process.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Used insurance rate standards to calculate premiums, refunds, commissions and adjustments.
- Retained strong medical terminology understanding in effort to better comprehend procedures.
- Precisely calculated refunds, premiums, and adjustments.
- Analyzed and interpreted policy language, medical records, and other relevant data to identify coverage issues.
Education
Associate of Science - Medical Billing And Coding
Indiana Business College
Anderson, IN06-2007
Timeline
Precertification Specialist
Hopebridge Autism Therapy Centers LLC
03.2023 - Current
Denial Specialist
Hopebridge Autism Therapy Centers LLC
05.2022 - Current
Precertification Specialist
APCM
03.2018 - 04.2022
Denial Specialist/Precertification Specialist
Northside ENT
11.2010 - 01.2017
Associate of Science - Medical Billing And Coding
Indiana Business College
Similar Profiles
Hali WilsonHali Wilson
Senior Behavior Analyst at Hopebridge Autism Therapy CentersSenior Behavior Analyst at Hopebridge Autism Therapy Centers
Jerrie WoodlandJerrie Woodland
Registered Behavior Technician at HopeBridge Autism CentersRegistered Behavior Technician at HopeBridge Autism Centers
Sinajai BostSinajai Bost
Registered Behavior Technician at Hopebridge Autism Therapy CenterRegistered Behavior Technician at Hopebridge Autism Therapy Center
Grace EganGrace Egan
Team Leader/Manager at Panera BreadTeam Leader/Manager at Panera Bread
Jill DuVallJill DuVall
Paralegal at Lee C. Christie - Christie Farrell Lee & BellParalegal at Lee C. Christie - Christie Farrell Lee & Bell