Heather Matheis
Newburgh
Summary
Organized Medical Biller thoroughly versed in medical billing and HIPAA requirements. Personable professional with 3+ years of hands-on experience claiming refunds, reviewing claims and maintaining billing reports, and 13+ years of customer service. Accommodating and helpful team player proficient in job-related billing software.
Overview
8
8
years of professional experience
Work History
Medical Billing Specialist
Confluent Health
Louisville KY
08.2021 - Current
- Conducted research on insurance policies, procedures, and regulations to ensure compliance with all applicable laws.
- Initiated collection efforts on unpaid accounts by contacting insurance companies or patients directly via phone or mail.
- Worked closely with clinical staff to ensure accurate coding practices were followed.
- Processed credit card payments from patients in accordance with office policy.
- Analyzed rejected claims and corrected errors as necessary before resubmitting them for payment.
- Submitted appeals for denied claims when appropriate according to the insurance company's criteria.
- Monitored aging accounts receivable balances ensuring timely resolution of outstanding balances.
- Reviewed patient records for accuracy and completeness of information in medical billing system.
- Resolved discrepancies between insurance companies and patients regarding payment of bills.
- Provided customer service support to patients who had questions about their bills or payments due.
- Maintained detailed records of all billing activities including denials, adjustments, and payments received.
- Verified the accuracy of claim data prior to submission to insurance carriers.
- Ensured HIPAA compliance by maintaining confidentiality of all patient information.
- Researched complex billing issues involving multiple providers or services rendered over a period of time.
- Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Prepared and attached referrals, treatment plans or other required correspondence to reduce incidence of denials.
- Collaborated closely with other departments to resolve claims issues.
- Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
Waitress
Bonefish Grill
Evansville
05.2017 - 08.2021
- Took orders for food and drinks and delivered them to guests.
- Served alcoholic beverages responsibly in accordance with state laws.
- Provided accurate change for cash transactions using a cash register system.
- Introduced chef-created menu items with genuine enthusiasm and salesmanship
- Assisted other wait staff members in times of heavy customer traffic.
- Answered questions about menu items, ingredients, and pricing.
- Developed positive relationships with regular customers through friendly conversation.
Education
High School Diploma -
Castle High School
Newburgh, IN05.2008
Some College (No Degree) - Nutrition And Wellness
University of Southern Indiana
Evansville, INSome College (No Degree) - Nutrition Sciences
University of Southern Indiana
Evansville, INSkills
- Hospitality service expertise
- Sales expertise
- Accurate money handling
- Excellent Communication
- Denial management
- Accounts receivable
- Patient billing
- Customer service
- Attention to detail
- Effective communication
- Problem solving
- Team collaboration
- Bill payment
- Collections management
- Quality-oriented team player
- WebPT software applications proficiency
- Medicare and medicaid process
- CPT knowledge
- HIPAA compliance
- CPT code modifiers
- Medical claims submission
- Account follow-up
- Medical record security
- Teamwork and collaboration
- Electronic claims
- Medical billing technology
- Insurance collections
- Commercial and private insurance
- Multitasking and organization
- Electronic health record software
- Strong drive to thrive
Timeline
Medical Billing Specialist
Confluent Health
08.2021 - Current
Waitress
Bonefish Grill
05.2017 - 08.2021
High School Diploma -
Castle High School
Some College (No Degree) - Nutrition And Wellness
University of Southern Indiana
Some College (No Degree) - Nutrition Sciences
University of Southern Indiana