Michele Schroeder

630-***-**** ad2v9r@r.postjobfree.com

Detail-oriented and dedicated Medical Billing Specialist with 5+ years of experience in healthcare revenue cycle management. Proficient in navigating the complexities of medical billing and coding, ensuring accurate and efficient reimbursement processes for healthcare providers. Well-versed in industry-standard software and compliance guidelines, maintaining strict adherence to confidentiality and regulatory requirements. Possesses strong analytical and problem-solving skills, along with excellent communication abilities to facilitate effective collaboration with healthcare professionals, insurance companies, and patients in resolving billing issues promptly. Highly Experienced in all payors, accounts payable, accounts receivable, self-pay accounts. Seeking an opportunity to leverage expertise in medical billing to contribute to the financial success of a reputable healthcare organization.

Work Experience

Patient Account Representative

TRC Staffing 12/2022 - 06/2023

Assigned to Medicare Advantage payors for claim status follow-up.

Assisted with resolving outstanding claims.

Worked to appeal any denials by providing additional/missing information.

Understanding and Knowledge of coordination of benefit and explanation of benefits

Verified documentation and eligibility of benefits.

Understanding and Knowledge of coordination of benefit and explanation of benefits.

Maintained client files.

Stayed up to date on complex insurance regulations.

Performed other administrative support duties as needed.

Insurance Follow Up Denial Specialist

Edward Elmhurst Health Care 08/2021 - 06/2022

Assigned to Commercial and Veterans payors for claim status follow-up.

Assisted with resolving outstanding claims.

Verify documentation and eligibility of benefits

Update insurance information for existing patients

Call to obtain pre-authorization and referrals for recommended services and procedures.

Submit appeals and reconsideration for denials by providing additional/missing information

Inform relevant clinical staff about denials

Stayed up to date on complex insurance regulations

Performed other administrative support duties as needed

Understanding and Knowledge of coordination of benefit and explanation of benefits

Appeals and Grievance Specialist

Annuity Health 03/2018 - 07/2021

Reviewed and appealed denials for all payors.

Researched various sources of information to determine appropriateness of appeal.

Completed various types of denial reviews, appeal, and further action.

Requested appropriate charge corrections for rebilling.

Added prior authorization to claim if missing and submit as corrected claim

Recommended or educated others on proper documentation, payer processes, and policies with a denial prevention strategic focus.

Escalated any discrepancies and issues encountered to supervisors in a timely manner.

Kept up to date on department and organization policies as well as payer and all regulatory and compliance rules and regulations.

Participated in any meetings, phone conferences or webinars as needed in order to properly process denials or expand knowledge regarding the appeal process, changing rules and regulations.

Education

Associate Degree in Applied Science Liberal Arts - Morton College

Skills

Excellent Customer service

Intensive Collection

Insurance Verification, Prior Authorization

Accounts Receivable Specialist

Denial Specialist

Athena, Availity, Centene, Epic, Meditech, Ecare, Onesource

Appeals and Grievance Specialist

Revenue Cycle Management

Advocate Health Care, Copley Memorial, MT Sinai, University of Chicago, ST Anthony Chicago, Innova HealthCare Systems

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