Venita Martin
Chattanooga
Summary
Detail-oriented Revenue Cycle Specialist with a proven track record in medical billing, denial management, and process improvement. Expertise in HIPAA compliance and analytical problem-solving drives accurate billing and enhances revenue accuracy.
Overview
18
18
years of professional experience
Work History
Revenue Cycle Specialist
HealthCare Strategies
Chattanooga, TN
11.2021 - Current
- Analyzed billing discrepancies to enhance revenue accuracy and resolve patient account issues.
- Implemented process improvements to streamline claims submission and reduce denial rates.
- Collaborated with cross-functional teams to optimize revenue cycle workflows and enhance operational efficiency.
- Reviewed and verified insurance eligibility to ensure compliance with healthcare regulations.
- Trained new staff on revenue cycle processes, improving team productivity and knowledge retention.
- Monitored accounts receivable aging reports to identify collection opportunities and minimize outstanding balances.
- Conducted regular audits of financial documentation for accuracy, facilitating timely reimbursement from payers.
- Increased revenue by identifying and resolving billing errors in a timely manner.
- Trained new team members on revenue cycle best practices, contributing to a more knowledgeable workforce.
- Enhanced customer satisfaction by promptly addressing and resolving billing disputes.
- Ensured accurate billing with thorough audits of patient accounts and insurance claims.
- Reached out to insurance companies to verify coverage.
- Achieved optimal reimbursement rates by verifying insurance coverage, eligibility, benefits, and authorization prior to service delivery.
- Contacted responsible parties for past due debts.
- Streamlined the revenue cycle process for improved efficiency and faster payment collection.
- Coordinated patient payment plans, balancing compassion with firmness to ensure timely payments while preserving positive patient relationships.
- Assisted patients in understanding complex billing statements, leading to increased trust between patients and healthcare providers.
- Provided regular updates on billing status to upper management through detailed reports.
- Maintained clear documentation of all activities related to unpaid claims or denied services.
Patient Service Representative
Erlanger Medical Center
Chattanooga, TN
07.2018 - 10.2021
- Managed patient scheduling and appointment coordination to enhance operational efficiency.
- Facilitated communication between patients and healthcare professionals to ensure seamless service delivery.
- Resolved patient inquiries and concerns, fostering a positive experience within the medical center.
- Implemented electronic health record systems to streamline patient information management and retrieval.
- Trained new staff on office procedures and best practices for patient interactions and support services.
- Participated in ongoing training programs related to HIPAA compliance, maintaining up-to-date knowledge on regulatory requirements.
- Verified insurance eligibility and coverage for patients.
- Handled sensitive patient concerns with professionalism and empathy, fostering an atmosphere of trust within the clinic.
- Provided exceptional customer service to patients, answering questions and addressing concerns.
- Managed patient registration process, confirming data accuracy and completeness.
- Used EPIC to schedule appointments.
- Maintained a well-organized front desk, contributing to a welcoming environment for patients and visitors.
- Handled customer service inquiries in person, via telephone and through email.
- Assisted patients in filling out check-in and payment paperwork.
- Facilitated patient registration by accurately entering demographic and insurance information into electronic health record systems.
- Took copayments and compiled daily financial records.
- Balanced deposits and credit card payments each day.
- Built and maintained positive working relationships with patients and staff.
- Actively participated in team meetings focused on improving workflows and enhancing overall practice performance.
- Handled complex insurance pre-authorization processes accurately, enabling timely delivery of necessary medical services.
- Coordinated referrals efficiently between primary care providers and specialists, ensuring a seamless patient experience.
- Managed waiting room operations effectively, addressing any issues or concerns that arose during peak hours.
- Reduced no-show rates through consistent appointment reminder calls, leading to improved clinic productivity.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Answered incoming calls, scheduled appointments and filed medical records.
- Provided excellent customer service to patients and medical staff.
Reimbursement Specialist
National Seating and Mobility
Chattanooga, TN
10.2014 - 07.2018
- Analyzed billing discrepancies and resolved issues to ensure accurate reimbursement processing.
- Collaborated with healthcare providers to verify insurance information and enhance claim submissions.
- Streamlined billing processes, resulting in faster payments from insurance companies.
- Increased revenue by identifying and rectifying errors in coding, pricing, and data entry.
- Managed high volume of claim submissions while maintaining strict adherence to deadlines for optimal reimbursement results.
- Contributed positively to workplace morale by actively participating in team meetings and offering support to colleagues when needed.
- Reduced aged accounts receivable balances through diligent follow-up on outstanding claims.
- Followed up on denied and unpaid claims to resolve problems and obtain payments.
- Supervised reimbursement team, ensuring compliance with federal and state regulations.
- Developed and implemented policies to improve reimbursement processes and reduce errors.
- Led training sessions for staff on new reimbursement systems and best practices.
- Collaborated with cross-functional teams to resolve complex billing issues promptly.
- Conducted regular audits of reimbursement records to identify areas for improvement and ensure accuracy in reporting data.
- Supervised a team of reimbursement specialists, ensuring timely and accurate billing of claims.
- Provided ongoing support to team members with challenging case scenarios, fostering professional growth and development within the department.
Claims Service Analyst
Cigna
Chattanooga, TN
05.2008 - 07.2014
- Resolved complex claims inquiries, ensuring accurate and timely responses to customer needs.
- Processed high-volume claims efficiently, ensuring adherence to company policies and regulatory requirements.
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Managed workload and priorities to meet claims processing meet deadlines.
- Maintained strict confidentiality when dealing with sensitive information about patients'' medical histories or personal details.
- Tracked and reported on claims processing metrics to aid senior management in making informed decisions.
- Reduced backlog of pending claims, prioritizing tasks effectively and efficiently.
- Achieved significant reductions in error rates, rigorously adhering to company guidelines and procedures.
Education
Bachelor of Science - Healthcare Administration
University of Phoenix
Tempe, AZ02-2028
Associate of Applied Science - Early Childhood Care And Education
Chattanooga State Community College
Chattanooga, TN05-2005
Skills
- Claims processing proficiency
- HIPAA compliance
- Professionalism and ethics
- Insurance verification
- Denial management
- Medical billing expertise
- Analytical problem solving
- Revenue cycle management
Affiliations
National Society of Leadership Success
Upsilon Phi Delta
Timeline
Revenue Cycle Specialist
HealthCare Strategies
11.2021 - Current
Patient Service Representative
Erlanger Medical Center
07.2018 - 10.2021
Reimbursement Specialist
National Seating and Mobility
10.2014 - 07.2018
Claims Service Analyst
Cigna
05.2008 - 07.2014
Bachelor of Science - Healthcare Administration
University of Phoenix
Associate of Applied Science - Early Childhood Care And Education
Chattanooga State Community College