Teressa Garber
New Virginia,IA
Summary
Results-driven claims management specialist with extensive experience in analyzing and resolving payer denials. Known for strong communication and collaboration skills, successfully coordinating with teams to ensure accurate claims processing and improve service delivery.
Overview
1
1
Certification
34
34
years of professional experience
Work History
Medicare Follow Up Rep II
UnityPoint Clinic
Des Moines, IA
10.2020 - Current
- Applied in-depth knowledge of Medicare coordination of benefits and federal regulations to enhance filing accuracy and efficiency.
- Reviewed payer denials, both contracted and non-contracted, to enhance claims management and reduce revenue loss.
- Reviewed and analyzed medical records to support disputed claims, ensuring accurate redetermination through provider portals.
- Analyzed coding discrepancies and coordinated with the relevant coding team for corrective measures. Executed claim adjustments and successfully resubmitted for review.
- Coordinated coding and billing review processes in response to patient requests, enhancing service delivery.
- Oversaw communication with credentialing liaison to resolve provider enrollment discrepancies affecting claims. Leveraged MSOW software to enhance operational efficiency in claims management.
Liability/Work Comp Follow Up Rep II
UnityPoint Clinic
Des Moines, IA
09.2018 - 10.2020
- Investigated and documented third-party liability for denied payer claims, expediting resolution process.
- Determined personal health insurance availability for claims post-liability benefits, ensuring compliance with payer timelines.
- Facilitated communication with payers to assess medical record requirements and verify maximum medical benefits or policy limits utilization.
- Analyzed injury claims through contracted payer portals to establish the existence of open claims.
- Established account registration processes to facilitate claims filing with non-contracted payers.
Insurance Credit Rep II
UnityPoint Clinic
Des Moines, IA
03.1998 - 04.2018
- Coordinated Medicare benefits with external payers, analyzing and determining rightful ownership of excess payments to ensure accurate financial management.
- Managed issuance of refund checks to carriers and oversaw daily audits within Epic and GMPS systems to maintain compliance and accuracy.
- Collaborated with accounts payable to reconcile weekly insurance carrier refunds, managed printing of checks and registers, and coordinated mailing of checks and documentation to relevant parties.
- Organized and preserved paper documentation for seven years while supporting accounts payable during yearly audit processes.
- Facilitated resolution of outstanding checks and reported non-claimed payments to Iowa, Illinois, and Wisconsin state treasuries.
Collections Assistant
UnityPoint Clinic
Des Moines, IA
08.1996 - 03.1998
- Executed in-house collection processes for outstanding medical claims, improving recovery rates on patient accounts.
- Directed overdue accounts to contracted collection agency, enhancing overall debt recovery efficiency.
- Oversaw monthly reporting of internal collections, addressing provider preferences to retain accounts and discussing patient account terminations due to non-payment.
Patient Account Representative
UnityPoint Clinic
Des Moines, IA
04.1992 - 08.1996
- Oversaw front desk operations, managing patient check-in and check-out processes.
- Streamlined collection of in-house insurance payments to enhance cash flow management.
- Balanced nightly billing amounts for providers to maintain accurate financial records. Made banking deposits to ensure timely access to funds. Balanced the petty cash drawer to support financial accountability.
- Managed recording of pharmacy refills to ensure timely medication access for patients.
- Compiled and organized lab reports for provider review and follow-up.
Education
No Degree - Gender Studies
Simpson College
IndianolaMedical Associates - Medical Associates
DMACC
Ankeny1990
Skills
- Skilled in Epic Software usage
- Experienced with MSOW software applications
- Claims processing
- Customer support
- Experience with Microsoft applications
- Detail-oriented communication
- Objective oriented
Certification
Certified Revenue Cycle Specialist
Timeline
Medicare Follow Up Rep II
UnityPoint Clinic
10.2020 - Current
Liability/Work Comp Follow Up Rep II
UnityPoint Clinic
09.2018 - 10.2020
Insurance Credit Rep II
UnityPoint Clinic
03.1998 - 04.2018
Collections Assistant
UnityPoint Clinic
08.1996 - 03.1998
Patient Account Representative
UnityPoint Clinic
04.1992 - 08.1996
No Degree - Gender Studies
Simpson College
Medical Associates - Medical Associates
DMACC