Yvonne Koonce
Grand Rapids,MI
Summary
Results-driven healthcare professional with experience in medical billing, denial management, and claims follow-up. Skilled in analyzing denied and underpaid claims, identifying root causes, and submitting timely appeals in compliance with payer guidelines. Proficient in Epic and knowledgeable in BCBS, Ccmmercial insurance, Medicare, Medicaid, and HIPAA regulations. Seeking a Claims Analyst role to improve reimbursement accuracy and support revenue cycle performance. Professional representative with robust experience and strong commitment to delivering exceptional results. Effective at collaborating within teams and adapting to changing needs to ensure reliability and success. Skilled in communication, problem-solving, and customer relations, with focus on achieving impactful outcomes. Valued for proactive approach, integrity, and ability to build lasting professional relationships.
Overview
22
22
years of professional experience
Work History
Billing and Follow-Up Representative II (Trainee)
Trinity Health
09.2021 - Current
- Review and research denied and underpaid claims across commercial insurance, Medicare, and Medicaid to identify root causes and ensure accurate reimbursement
- Prepare and submit appeals with supporting documentation in accordance with payer guidelines
- Communicate with insurance carriers to follow up on claim status and resolve outstanding denials
- Analyze denial trends and identify recurring issues, contributing to process improvement efforts
- Collaborate with billing, coding, and internal teams to correct discrepancies and improve claim accuracy
- Maintain detailed documentation and update claim activity notes in Epic
- Ensure compliance with HIPAA and payer regulations
- Manage multiple accounts while meeting productivity and quality standards
Junior Mortgage Processor
Lake Michigan Credit Union
10.2020 - 09.2021
- Reviewed and verified documentation for accuracy and compliance with regulatory requirements
- Identified discrepancies and conducted research to resolve issues efficiently
- Coordinated with multiple stakeholders to ensure timely processing and completion of files
- Maintained organized records and detailed documentation of file activity
- Demonstrated strong analytical and problem-solving skills in a fast-paced environment
- Via Snelling
Medical Reimbursement Specialist
Advanced Radiology Services
Grand Rapids, MI
04.2004 - 02.2020
- Review, submit, and follow up on insurance claims to ensure prompt reimbursement
- Analyze denied or underpaid claims and take appropriate action for resolution, including appeals and corrections
- Verify patient insurance eligibility, benefits, and coverage details
- Interpret Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs) to reconcile payments
- Identify trends in claim denials and recommend process improvements to reduce future issues
- Communicate with insurance companies to resolve discrepancies and obtain claim status updates
- Ensure compliance with payer guidelines, billing regulations, and coding standards (CPT, ICD-10, HCPCS)
- Collaborate with billing, coding, and clinical teams to correct claim errors
- Maintain accurate documentation of claim activity and follow-up efforts
- Stay up to date on changes in insurance policies, reimbursement guidelines.
- Experience in medical billing, claims processing, or insurance reimbursement
- Knowledge of commercial insurance, Medicare, and Medicaid payer requirements
- Strong understanding of denial management and appeals processes
- Familiarity with CPT, ICD-10, and HCPCS coding systems
- Excellent analytical and problem-solving skills
- Strong attention to detail and organizational skills
- Effective communication skills (written and verbal)
- Proficiency in Electronic Health Records (EHR) and billing software.
- Preferred Qualifications:
- Associate or Bachelor’s degree in Healthcare Administration, Health Information Management, or related field
- Certification such as Certified Professional Biller (CPB) or Certified Coding Specialist (CCS)
- Experience with revenue cycle management systems
- Led initiatives to streamline claims processing, reducing turnaround time for reimbursements.
- Monitored changes in healthcare regulations to ensure ongoing compliance with reimbursement standards.
- Contributed towards a smooth functioning work environment by offering assistance when needed while maintaining a pleasant demeanor.
- Worked effectively in fast-paced environments.
Education
Certificate - Medical Business
National Education Center
Wyoming, MI09.1995
Finance
Davenport University
Grand Rapids, MIHigh School Diploma -
Union High
Grand Rapids, MI06.1986
Skills
- Goal-oriented mindset
- Data entry proficiency
- Records management
- Customer support
Root Cause Analysis
Claims Review
Appeals & Resolution
Insurance Follow-Up
Payer Communication
Commercial Insurance
Medicare
Medicaid
Medical Billing & Coding
Epic (EHR)
Healthcare Systems
HIPAA Compliance
Documentation & Claims Tracking
Process Improvement
Trend Identification
Cross-Functional Collaboration
Data Accuracy
Quality Assurance
Epic
Medical Manager
Health Pac
Practice Partners
IDX
PCS
Mortgage Flex
Symitar/Episys
Microsoft Excel
Microsoft Outlook
Microsoft Word
Claims tracking
Account research
Denial follow-up
Additional Qualifications
- Strong understanding of medical terminology, anatomy, ICD-9, and CPT coding
- Proven ability to analyze data and identify trends in claims and denials
- Excellent communication and organizational skills
- Ability to work independently and manage workload under minimal supervision
- Committed to ongoing learning of payer policies and billing regulations
Timeline
Billing and Follow-Up Representative II (Trainee)
Trinity Health
09.2021 - Current
Junior Mortgage Processor
Lake Michigan Credit Union
10.2020 - 09.2021
Medical Reimbursement Specialist
Advanced Radiology Services
04.2004 - 02.2020
Certificate - Medical Business
National Education Center
Finance
Davenport University
High School Diploma -
Union High