Medical billing & Collections Professional
Resume:
DENISE M. C. HOOKS
Conroe, TX *****
️ **********@*****.***
PROFESSIONAL SUMMARY
Results-driven Revenue Cycle Management (RCM) Professional with extensive experience across front-end and back-end healthcare revenue cycle operations, including hospital and physician billing. Proven ability to manage high-volume workloads, resolve complex claims and denials, conduct audits, and support team productivity while meeting strict deadlines. Recognized for strong analytical skills, attention to detail, and effective communication with payers, providers, patients, and cross-functional teams.
CORE COMPETENCIES
PROFESSIONAL EXPERIENCE
Senior Patient Accounts Specialist
Emerus Healthcare Holdings – The Woodlands, TX
July 2023 – September 2025
Reviewed and approved credit balance refund requests for multiple team members, ensuring payer compliance and accuracy.
Conducted quarterly audits on 40+ accounts to identify trends, errors, and process improvements.
Assigned and tracked return mail and daily workloads for team members.
Generated and distributed weekly and ad hoc operational reports.
Served as a key liaison with collection agencies, insurance payers, facilities, and patients.
Resolved overpayments, underpayments, and complex claim discrepancies.
Reviewed EOBs and EDI reports (835/837) to identify denials and rejections.
Processed hospital claims, adjustments, and self-pay requests.
Filed and tracked appeals and grievances, including medical necessity reviews.
Supported team engagement through regular meetings and ongoing communication.
Revenue Cycle Quality Specialist
Addison Group – Houston, TX
January 2023 – July 2023
Managed follow-up with insurance payers to resolve outstanding reimbursements.
Analyzed rejected and denied claims and obtained documentation to support medical necessity.
Filed appeals and ensured timely filing compliance.
Updated patient demographics and insurance information to reduce claim errors.
Reviewed aged A/R accounts and escalated issues for correction and posting.
Worked from productivity spreadsheets to meet performance metrics.
Reviewed EDI rejection reports and coordinated resubmissions.
Accounts Receivable Specialist
Preventice / Boston Scientific – Houston, TX
August 2020 – October 2022
Managed insurance follow-up and denial resolution for high-volume A/R accounts.
Processed cash posting, adjustments, and reconciliations to maintain accurate balances.
Reviewed medical records to support appeals for medical necessity.
Generated invoices, posted payments, and followed up on overdue balances.
Communicated with patients, facilities, and payers to resolve billing disputes.
Maintained accurate documentation and ensured timely claim resubmissions.
Orthopedic Clinic Biller & Administrator
Healthcare Media, LLC – Spring, TX
July 2019 – February 2020
Submitted and followed up on orthopedic claims for multiple providers.
Resolved denials and processed adjustments and self-pay accounts.
Updated insurance and demographic data to improve claim accuracy.
Filed appeals and monitored productivity reports.
Nursing Home Medicaid Billing Specialist
HMG Services – The Woodlands, TX
September 2018 – December 2018
Managed Medicaid billing for multiple long-term care facilities.
Filed appeals and grievances and followed up on unpaid balances.
Communicated with patients, payers, and verification teams to resolve issues.
Maintained detailed account notes and collection activity.
C Medical Biller Medical Coder
Visualuations – Spring, TX
June 2017 – August 2018
Posted insurance and patient payments (ERA and manual).
Worked general A/R and aged buckets to reduce outstanding balances.
Reviewed and corrected claim rejections using EDI reports.
Managed hospital billing and FQHC collections.
Hospital Biller / Collections (Contract)
FMA Alliance – Addison Group, Houston, TX
March 2017 – May 2017
Filed appeals and reviewed EOBs for underpayments and denials.
Refiled claims to primary, secondary, and tertiary payers.
Medical Biller Medical Coder Client Representative
Parallon / HCA – St. Louis, MO
February 2013 – November 2016
Managed hospital billing and claims resolution across multiple facilities.
Educated providers on coding and denial trends.
Audited aged accounts to ensure timely filing compliance.
Created Excel reports analyzing denial trends and projected revenue.
Supported month-end closing, invoicing, and fee schedule maintenance.
Served as a primary contact for patients regarding benefits and financial responsibility.
EDUCATION
Certificate – Healthcare Careers 1992
St. Louis College of Health Careers
High School Diploma 1984
O’Fallon Technical High School GPA: 3.0
ADDITIONAL SKILLS
Excel Reporting & Data Analysis
Credentialing Support
NCCI Edits
Team Training & Mentorship
Compliance & Quality Review
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