RCM-System analyst
Resume:
Heather Anderson
Dundalk, MD *****
*******.*****@*****.***
Authorized to work in the US for any employer
Work Experience
RCM System Analyst - CPTM
ADAPT HEALTH - Remote
May 2022 to Present
• Review EHR encounters, medical records, case management and utilization review notes and various other health information documents to ensure proper coding and billing guidelines are applied.
• Review and make appropriate corrections to assigned CPT/HCPCS on hospital billing accounts to help ensure the integrity of gross revenue reported on facility claims.
• Collaborate with CBO, clinical, coding/HIM and other departments as necessary on identified missing codes and missing charges.
• Perform charge capture audits, identify trends and implement revenue capture measures through system build, clinical education, and/or revenue cycle process improvement methods.
• Monitor charge reconciliation reports to identify trends including compliance issues, missing charges and areas of vulnerability.
• Evaluate current charging and coding structures and processes in clinical departments to ensure appropriate capture and reporting of revenue and compliance with government and third-party payor requirements.
• Effectively and efficiently work Cerner-assigned (or other EHR once implemented) work queues with a focus on avoiding repetitive errors.
• Work with HIT to recommend and design Cerner edits to promote accurate, efficient, compliant billing practices.
• Provide coding and charge capture education to clinical departments, as needed.
• Collaborate with coding/HIM, billing and collections to detect revenue opportunities and/or reimbursement issues stemming from denials and underpayments.
• Conduct virtual meetings with clinical department or operational departments, if needed/requested, to discuss revenue integrity issues and results
• Assist with related special projects as assigned by supervisor. CPAP Coordinator/PAP Specialist
Americas healthcare at home / ADAPT HEALTH - Remote February 2020 to March 2023
Providing consistent, superior customer service to patients. Taking and processing patient supply orders via database, phone or email. Entering all ongoing care patient supply orders into billing software on a timely basis. Managing leads from our manual call list.
Ensuring that all patients' questions and issues are resolved quickly. Directing patients to an RT for an appointment if needed. Discussing shipping methods/options with patient and charging patients appropriately. Updating demos, and prescription updates to companies billing software. Enter new insurance or auths into medical billing software. Checking web-tools for patients eligibility of insurance benefits. Document management.
Front Office Manager/Assistant General Manager
Hoffman Chiropractic - Parkville, MD
December 2015 to February 2020
Handle scheduling patients.
Collecting Co-Pays.
Verifying insurances/eligibility and benefits, resubmitting claims, calling out to insurance companies to get unpaid claims paid.
Sorting mail
Transferring patients
Maintaining an orderly work area
Laundering towels and gowns used in the office.
Maintaining other inventories. Handling all cash wraps or petty cash. Managing employee schedules and potential conflicts Taking inventory of office supplies and order more if needed. Helping establish and maintain office procedure.
Assisting senior management team when needed.
Dealing with staff recruitment.
Attending seminars and training.
Review client bills for accuracy and completeness and proactively obtain any missing payer information for inclusion
Post adjustments, transfer of responsibility, and refunds, when needed, and update accounting records accordingly
Prepare invoices, reconcile billing, compile reports and other documents using billing software, and field related questions from internal teams and customers Submit insurance claims and follow up on unpaid, rejected, or denied claims to resolve and resubmit when required
Answer all client questions related to account status, activity, and outstanding charges Handle PIP/Workman Comp Claims.
Working with Auto insurance company to get settlements. Feeding Assistant
Erikson Living (Oakcrest) - Baltimore, MD
August 2013 to June 2015
August 2013-Present
• Feeding the elderly
• Knowing what residents can and can't eat for that week, Regular Diet, Give Beverages, Feed them, help with food choices.
• Help Resident to their room
• Working with elderly with Alzheimer's and Dementia
• Helping with Activities
Support Services Representative
Richcroft - Hunt Valley, MD
January 2014 to July 2014
Helping someone who has a Developmental Disability. Teaching her new things, how to live a positive life. Sales Associate
Kid to Kid
August 2011 to January 2012
Provide a variety of services, from helping you pick out items to ringing up your purchases.
• Maintain a neat floor, and put new inventory on the sales floor
• Efficiently and accurately completing sales and service transactions at the cash wraps.
• Handle customer issues that may arise on the sales floor. Achievements
Education
Bachelor's in Forensic Psychology
Southern New Hampshire University - Manchester, NH July 2018 to December 2022
Associate in Human Health Services
Iowa Central Community College - Fort Dodge, IA
January 2014 to January 2017
High school diploma
Bel Air High School - Bel Air North, MD
2007 to 2011
Skills
• Back Office
• Front Desk
• Front Office
• Electronic Medical Records (4 years)
• Electrical Stimulation (5 years)
• Insurance Verification (5 years)
• Computer Skills (10+ years)
• Claims Processing (5 years)
• ICD-10 (5 years)
• Customer Service (6 years)
• Insurance Verification (6 years)
• Microsoft Office (10+ years)
• Multi-Line Phone System (5 years)
• Dictation (2 years)
• Medical Scheduling (3 years)
• CPT Coding
• Medical Billing
• Medical Terminology
• Medical Office Experience
• ICD-9 (5 years)
• DME
• HCPCS
• Medical coding
• Documentation review
• DME (3 years)
• Medical receptionist
• Medical collection
• Medicare
• Typing
• Data collection
• Revenue cycle management (Less than 1 year)
• Revenue management (1 year)
• Product lifecycle management (1 year)
• HIPAA
• Patient Care
• Document Management
• Alzheimer's Care
• Microsoft SharePoint
• Operating systems
• ICD coding (5 years)
Languages
• English - Expert
Awards
Promotion
May 2022
Went from a PAP Specialist to a RCM System Analyst- CPTM Promotion Certifications and Licenses
CNA/HHA
February 2017 to February 2019
It’s expired
First Aid Certification
Assessments
Data entry: Accuracy — Highly Proficient
January 2020
Entering data quickly and accurately
Full results: Highly Proficient
Customer service — Proficient
August 2021
Identifying and resolving common customer issues
Full results: Proficient
Customer focus & orientation — Proficient
August 2021
Responding to customer situations with sensitivity Full results: Proficient
Administrative assistant/receptionist — Proficient August 2021
Using basic scheduling and organizational skills in an office setting Full results: Proficient
Working with MS Word documents — Proficient
January 2020
Knowledge of various Microsoft Word features, functions, and techniques. Full results: Proficient
Attention to detail — Proficient
July 2021
Identifying differences in materials, following instructions, and detecting details among distracting information
Full results: Proficient
Receptionist — Familiar
October 2019
Using basic scheduling, attention to detail, and organizational skills in an office setting. Full results: Familiar
Electronic health records: Best practices — Familiar July 2021
Knowledge of EHR data, associated privacy regulations, and best practices for EHR use Full results: Familiar
Problem solving — Familiar
January 2020
Measures a candidate's ability to analyze relevant information when solving problems Full results: Familiar
Medical receptionist skills — Proficient
August 2021
Managing physician schedules and maintaining accurate patient records Full results: Proficient
Medical billing — Proficient
October 2019
Understanding the procedures and forms used for medical billing. Full results: Proficient
Protecting patient privacy — Proficient
August 2021
Understanding privacy rules and regulations associated with patient records Full results: Proficient
Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.
Additional Information
CNA, CMT, CPR and First Aid Certified
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