Terrie Moorer
Summary
With a proven track record at Community Health Systems, CHS, I excel in claims processing and customer service, significantly enhancing patient satisfaction and compliance. My expertise in Medicare knowledge and strong communication skills have led to impactful fraud prevention measures and efficient problem-solving, showcasing my ability to drive improvements in healthcare billing and patient care.
Developed expertise in healthcare systems and customer service within high-demand environment, seeking to transition into new field. Demonstrated ability to navigate complex regulations and provide exceptional support to clients, ensuring their needs are met efficiently. Aiming to leverage these transferable skills to contribute effectively in different industry.
Extensive background in Medicare services with proven track record of enhancing patient satisfaction and streamlining claims processes. Demonstrated expertise in compliance and communication, ensuring smooth operations and effective team collaboration.
Overview
17
17
years of professional experience
Work History
Medicare Specialist II
Community Health Systems, CHS
04.2022 - Current
- Implemented preventative measures for potential fraud or abuse cases by diligently reviewing claim submissions for inconsistencies or red flags.
- Improved patient satisfaction by effectively managing Medicare claims and resolving issues promptly.
- Educated patients on their benefits, coverage limits, and rights under the Medicare program, empowering them to make informed decisions about their healthcare needs.
- Provided timely responses to inquiries from patients, healthcare providers, and colleagues regarding Medicare policies and procedures.
Health Benefits Advisor
Wisconsin Physician Service Health Insurance, WPS
04.2021 - 03.2022
- Educated employees on their health benefits during group presentations, increasing overall understanding and utilization of available services.
- Liaised between clients and internal staff to resolve problems involving access, payment of bills and eligibility issues concerning medical care.
- Educated clients on products over phone or face-to-face presentations, highlighting changes in policies offered or advantages over competitor services.
- Improved client satisfaction by providing clear and concise information on health benefit plans and options.
Workers' Compensation Claims Assistant
United Parcel Services, UPS
02.2020 - 02.2021
- Checked documentation for accuracy and validity on updated systems.
- Verified client information by analyzing existing evidence on file.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Generated, posted and attached information to claim files.
Medicare Billing Specialist
Prime HC Providence Medical Ctr St Joseph Hosp
12.2013 - 12.2019
- Maintained up-to-date knowledge of changing Medicare regulations and guidelines, ensuring accurate and compliant billing practices.
- Contributed to overall practice growth by analyzing billing data to identify opportunities for expanding services covered under Medicare.
- Advised senior management on recommended improvements to the overall Medicare billing process, increasing efficiency and reducing potential for errors.
- Provided exceptional customer service by promptly addressing patient inquiries or concerns related to their Medicare bills.
- Participated in networking events within the healthcare industry to stay informed about changes affecting the field of medical billing.
- Enhanced interdepartmental communication by serving as a liaison between the billing department and clinical staff regarding Medicare-related issues.
- Increased revenue recovery through diligent follow-up on outstanding Medicare claims and appeals.
- Resolved complex billing issues by conducting thorough research and collaborating with relevant parties.
- Audited patient accounts to identify discrepancies in billed services, correcting errors to ensure proper reimbursement.
- Collaborated with healthcare providers to obtain necessary documentation for accurate Medicare billing.
- Reduced claim denials by meticulously reviewing and correcting billing data prior to submission.
- Managed a high volume of Medicare claims, ensuring timely submission and payment for medical services rendered.
- Trained new staff members on Medicare billing procedures and best practices, improving team efficiency.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Verified insurance of patients to determine eligibility.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
Health Insurance Billing Specialist
St Lukes Health Systems
03.2008 - 11.2013
- Minimized errors in claims submissions through regular cross-checking of CPT and ICD codes against medical documentation.
- Assisted colleagues during peak workload periods, demonstrating strong teamwork and commitment to overall departmental success.
- Collaborated with medical staff to obtain necessary documentation, enabling timely submission of accurate claims.
- Streamlined billing processes for improved efficiency through the implementation of electronic payment systems.
- Ensured strict adherence to HIPAA guidelines while handling sensitive patient information during the billing process.
- Increased revenue collection by diligently pursuing outstanding claims and negotiating with insurance companies.
- Maintained strong working relationships with insurance providers, fostering open communication channels for claim resolution.
- Provided exceptional customer service to patients when discussing billing matters, demonstrating empathy and professionalism at all times.
- Enhanced claim accuracy by meticulously reviewing and verifying patient insurance information.
- Maintained up-to-date knowledge of insurance policies and changes, ensuring accurate billing practices.
- Used data entry skills to accurately document and input statements.
Education
Associates - Healthcare Management
Penn Valley Community College
Kansas City, MOCertification - Healthcare
Kansas City College of Medical And Dental
Kansas City, MOSkills
- Strong communication skills
- Claims processing proficiency
- Customer service expertise
- Networking and relationship building
- Medical terminology
- Conflict resolution techniques
- Negotiation tactics
- CMS guidelines
- In-depth medicare knowledge
- Healthcare industry experience
- Teamwork
- Customer service
- Problem-solving
- Time management
- Organizational skills
- Flexibility
- Self motivation
Timeline
Medicare Specialist II
Community Health Systems, CHS
04.2022 - Current
Health Benefits Advisor
Wisconsin Physician Service Health Insurance, WPS
04.2021 - 03.2022
Workers' Compensation Claims Assistant
United Parcel Services, UPS
02.2020 - 02.2021
Medicare Billing Specialist
Prime HC Providence Medical Ctr St Joseph Hosp
12.2013 - 12.2019
Health Insurance Billing Specialist
St Lukes Health Systems
03.2008 - 11.2013
Associates - Healthcare Management
Penn Valley Community College
Certification - Healthcare
Kansas City College of Medical And Dental
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