Healthcare Billing & Reimbursement Specialist

Mary Christine McKibben

*** ** ****** **** ****, Edgewood, TX 75117

903-***-**** *****************@*****.*** Professional Summary

Detail-oriented healthcare billing specialist with extensive experience in Medicaid/Medicare claims, reimbursement processes, and client support through Texas Health & Human Services. Proven ability to manage complex caseloads, resolve billing issues, and ensure compliance with HHSC standards. Seeking to contribute expertise as a Reimbursement Officer at Terrell State Hospital.

Professional Experience

• Reimbursement Officer I/II

• Texas Health & Human Services – Terrell State Hospital, Terrell, TX

• Jan 2020 – Present

• Submitted and tracked Medicaid/Medicare claims, posted payments, and corrected errors.

• Collaborated with front office and billing team to verify insurance and patient eligibility.

• Handled billing inquiries, patient account updates, and self-pay collection tasks.

• Monitored remittance advices and claim denials to ensure timely resolution.

• Processed claims for Medicaid, Medicare Part A/B/D, and commercial insurers for psychiatric care services.

• Coordinated physician enrollment and revalidation processes with Medicare.

• Generated charge reports using AVATAR and CARE; verified service coding (CPT/ICD-10).

• Handled denials, performed claim audits, and managed monthly reconciliation reports.

• Assisted in responding to payer correspondence and prepared for audits.

• Maintained documentation in accordance with federal billing standards and HHSC procedures.

• In-Home Family Support Worker (Community Care Worker I)

• Texas Health & Human Services – Canton, TX

• Jan 2015 – Dec 2019

• Conducted home visits to assess clients' daily living needs and determine program eligibility.

• Completed functional assessments and verified income/resources for state services.

• Developed individualized service plans with families, providers, and HHSC case managers.

• Monitored service delivery and authorized continued support based on case needs.

• Ensured proper documentation in TIERS and CARE systems for state compliance.

• Managed 50+ client cases with consistent on-time documentation and follow-up. Skills & Tools

• Billing Software: AVATAR, CARE, TIERS, Microsoft Excel

• Coding: CPT, ICD-10, HCPCS

• Medicaid/Medicare billing & eligibility processes

• Claims reconciliation and denial management

• Client intake, service planning, and case documentation

• Strong written/verbal communication and inter-agency collaboration

• Spanish speaking and reading proficiency

Education

High School Diploma – Edgewood, TX – 2000

Strayer University – Online – Pursuing B.S. in Health Administration (Expected 2026) Certifications

• Medical Billing & Coding Certificate

• HIPAA Compliance Training – 2022

• Family Support Services – HHSC Certification

Other Qualifications

• Valid Texas Driver’s License

• Available for 85% field travel and flexible hours

• Familiar with HHSC confidentiality, billing, and reporting standards

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