Resume

Administrative Assistant Data Entry

Location:

Raleigh, NC, 27603

Salary:

27.00 hour

Posted:

January 12, 2023

Contact this candidate

Resume:

HEATHER GOELLER

REVENUE CYCLE AND BILLING SPECIALIST

Raleigh, NC 27603 • 919-***-**** • adul5w@r.postjobfree.com Professional Summary

Methodical Revenue Cycle Specialist with strong attention to detail and in-depth understanding of billing procedures. Excellent planning and problem-solving abilities. Prepared to bring over 20 years of related experience to a dynamic position with room for career growth. Skills

• Financial and operational reporting

• Analyzing claims

• Debt collection procedures

• Managing records

• Interpersonal Communication

• Revenue Cycle Management

• Insurance Benefits Understanding

• HIPAA Regulations

• Medical Terminology Knowledge

• Team Training and Mentoring

• EPIC and SSI Proficiency

• Account reconciliation specialist

Work History

Senior Revenue Cycle Specialist, 04/2015 to 11/2021 Rex Hospital – Raleigh, NC

• Processed Late Charge/Credits, reconciled account discrepancies

• Met productivity goals at 200% weekly

• Processed and split billing of Provider Liable claims

• Created Related Accounts for proper billing of Ambulance charges

• Analysis and processing of Claim Skip Report

• Reviewing, verifying and processing billing for Research and Clinical Trial claims

• Produced Daily Billing reports

• Collaborated with other departments to reconcile billing/denial issues

• Analysis of claims in Stop Bill and DNB

• Consolidated financial data and materials for key leadership meetings.

• Mentored and trained employees

• Extensive knowledge and proficiency in EPIC and SSI

• Identified and resolved payment issues between patients and providers.

• Monitored and analyzed financial and operational data trends.

• Improved financial status by analyzing results, monitoring variances and recommending actions to management staff.

• Researched and verified insurance coverage.

• Contacted responsible parties for past due debts.

• Created and maintained precise and accurate reports.

• Balanced and reconciled accounts.

Medicare/Government billing specialist, 03/2012 to 04/2015 Rex Hospital – Raleigh, NC

• Billing for out and inpatient services

• Appealing denied claims, filing corrected claims

• Collaborated with other departments on coding/billing issues

• Proficient in DDE and CCSM denial/RTP workflow

• Completed keeping Work Ques current and timely

• Mentored and supported employees

• Communicated with insurance providers to resolve denied claims and resubmitted.

• Collected payments and applied to patient accounts.

• Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers. Front Desk, 10/2010 to 03/2012

Triangle Physicians Network – Morrisville, NC

• Scheduling for multi physician practice

• Insurance verification

• Obtain and track referrals and authorizations

• Billing & Coding ICD-9 and CPT

• Implement and create Policy/Procedure and forms for practice

• End of day/month closing

• Answered multi-line phone system to respond to inquiries and transfer calls to correct departments and personnel.

• Greeted patients at front desk and engaged in pleasant conversations while managing check-in process.

• Maintained files and records by implementing effective filing systems that boosted efficiency and organization.

• Confirmed important personal and payment information for compliance with security and payment card industry standards.

• Trained new team members on company procedures, customer service and issue resolution.

• Used quick response and dynamic service skills to build relationships with patients and improve customer retention rate.

• Kept accounts in balance and ran daily reports to verify totals.

• Entered and updated sensitive customer information during check-ins. Office Manager, 09/2008 to 08/2009

Colville Trucking Co – Raleigh, NC

• Managed 8 Trucks/Drivers

• Implementing DOT regulations

• Coordination truck loads and delivery schedules

• Billing

• End of month closing

• Maintained computer and physical filing systems.

• Established workflow processes, monitored daily productivity and implemented modifications to improve overall performance of personnel.

• Updated reports, managed accounts and generated reports for company database.

• Optimized organizational systems for payment collections, AP/AR, deposits and record keeping.

• Coached new hires on company processes while managing employees to achieve maximum production.

Administrative Assistant to the Director, 10/2003 to 08/2007 AdvoCare, Inc./Town Total Nutrition – Farmingdale, NY

• Restocked supplies and submitted purchase orders to maintain pharmacy inventory.

• Edited documents to improve accuracy of language, flow and readability.

• Interacted with discharge planners and Physicians to purchase and set up equipment and services.

• Intake for new patients

• Obtaining authorization and pre-certification

• Insurance verification

• Nursing care coordination

• Report lab results to ordering physician

• Patient Plan of Treatment

• Track patient therapy, therapy changes and wasted doses

• Delivery and pick up coordination

• Manage accounts receivable

• Coding CPT and ICD-9

• Executed record filing system to improve document organization and management. Medicare Specialist, 10/2001 to 11/2002

Advanced Healthcare Resources – Hauppauge, NY

• Prepared outstanding claims reports and end of month closing reports

• Processed Medicare Pre-submission and Validation reports

• Correct ICD-9 and CPT coding and appeal denied claims

• Collaborated with clients to resolve account issues and trouble shoot system and program errors

• Communicated with insurance providers to resolve denied claims and resubmitted.

• Collected payments and applied to patient accounts.

• Adhered to established standards to safeguard patients' health information.

• Orchestrated payment posting, accounts receivables and collections. Medicare/Medicaid Billing Supervisor, 03/1998 to 10/2001 East Meadow Management Group – Westbury, NY

• Supervised 7 administrative team members and provided constructive feedback, resulting in higher morale and increased employee retention.

• Train, oversee and delegate work to employee

• Run tape submissions to Medicare and Medicaid

• Follow up and appeals on outstanding/denied claims

• Update credentialing and group enrollment for providers

• Performed account reconciliations and resolved variances.

• Developed and implemented improvements to billing system to maximize efficiency, reduce delinquency and increase accuracy.

• Oversaw financial operations, producing invoices, processing payments and preparing deposits.

• Identified, researched and resolved billing variances to maintain system accuracy and currency.

• Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.

• Coordinated individual duties after careful evaluation of each employee's skill level and knowledge.

Account Representative, 09/1996 to 03/1998

Intertech Penta Group – Syosset, NY

• Cardiology Unit

• Worked in the following departments: data entry, billing, cash posting, follow up and appeals

• Handled all Medicare, Medicaid, Commercial, NF and WC correspondence

• Corresponded with patients regarding insurance questions

• Verified insurance coverage and obtained authorization Education

Associates Degree: Occupational Health, 2006

New York College of Health Professions - Syosset, NY A+ Certified Professional, CompTIA: 2001

Hendricks Institute - Lindenhurst, NY

Certificate in Windows 2000 Professional: 2001

Hendricks Inst - Lindenhurst, NY

Certificate in Windows 2000 Server: 2001

Hendricks Inst - Lindenhurst, NY

Certificate in Windows 2000 Network Infrastructure Admin: 2001 Hendricks Inst - Lindenhurst, NY

Certified Medical Coding Specialist: 1997