Heather Gilbee
Thornton
Summary
Experienced and detail-oriented professional with a strong background in medical insurance, claims processing, and accounts receivable management. Skilled in accurately processing and reconciling medical and dental claims, as well as posting payments. Demonstrated expertise in managing business accounts receivable, processing credits and adjustments, and ensuring compliance with industry regulations and standards. Proficient in troubleshooting discrepancies, optimizing payment cycles, and improving financial workflows. Recognized for consistently delivering high-quality results in fast-paced environments, prioritizing customer service and operational efficiency.
Overview
9
9
years of professional experience
Work History
Accounts Receivable Specialist
ProEgg Inc.
11.2023 - Current
- Managed accounts receivable processes, including customer outreach, payment application, credit creation, reconciliation, helped with end of month closing, lockbox, and adjustment processing
- Coordinated with a team of 5 to ensure accurate order fulfillment and resolution of discrepancies
- Conducted regular follow-ups with customers to address payment issues and resolve disputes
- Maintained detailed records of transactions and adjustments, ensuring financial accuracy and compliance
- Contributed to a 15% decrease in overdue accounts by optimizing invoicing and collection systems.
Accounts Receivable Specialist
University of Colorado Denver | Anschutz
01.2021 - 11.2023
- Accomplished Accounts Receivable Specialist with a focus on insurance follow-up and medical records requests within a large hospital setting encompassing over3000 providers
- Proven track record of meticulously managing accounts receivable processes, ensuring accurate and timely resolution of insurance claims and reimbursements
- Expertise in navigating insurance portals to track claim statuses, identify discrepancies, and facilitate efficient claims resolution
- Collaborated effectively with insurance companies, healthcare providers, and internal teams to resolve claim denials.
- Skilled in processing medical records requests in compliance with industry standards and privacy regulations
- Detail-oriented and results-driven, committed to optimizing revenue cycles, reducing outstanding balances, and contributing to the financial health of the hospital while providing exceptional service
Medical Records Specialist
Cornerstone Orthopedics and Sports Medicine/Orthopedic Centers of Colorado
09.2020 - 11.2020
- Experienced Medical Records Specialist with a focus on managing workers' compensation requests within a busy orthopedic office
- Proven track record of efficiently handling and processing medical records, ensuring timely and accurate fulfillment of workman's compensation documentation
- Skilled in navigating Electronic Health Record (EHR) systems and maintaining strict adherence to privacy regulations such as HIPAA
- Expertise in collaborating with orthopedic practitioners, insurance carriers, and legal teams to facilitate seamless workers' compensation claims processing
- Detail-oriented and organized, with a strong ability to gather and compile relevant medical information to support claims and legal proceedings
Claims Coordinator
OrthoFi
05.2019 - 07.2020
- Results-driven claims coordinator with a specialized focus on orthodontic claims and appeals within a prominent third-party billing company
- Proven track record of meticulously managing complex orthodontic claims, from submission to reimbursement, while consistently ensuring compliance with industry regulations and coding standards
- Expertise in crafting compelling appeals by analyzing denied claims, gathering relevant documentation, and presenting well-reasoned arguments for maximum claims resolution
- Adept at collaborating closely with orthodontists, insurance carriers, and internal teams to expedite appeals and secure deserved reimbursements
- Detail-oriented and proactive, dedicated to optimizing processes, reducing claim denials, and delivering exceptional service
- Committed to maintaining accuracy, efficiency, and client satisfaction in orthodontic claims and appeals
Claims Processor
Anthem
09.2017 - 04.2019
- Detail-oriented professional with a comprehensive background in processing medical and dental claims within the health insurance sector
- Proficient in reviewing and analyzing complex claims documents to ensure accuracy, adherence to policy guidelines, and regulatory compliance
- Demonstrated ability to efficiently navigate claims processing software and databases, expediting the claims approval process
- Exceptional communication skills, enabling effective collaboration with healthcare providers, policyholders, and internal teams to resolve discrepancies and expedite claims resolution
- Proven track record of maintaining high productivity levels while upholding quality standards
Customer Service Rep
Anthem
05.2016 - 09.2017
- Managed accounts receivable processes, including customer outreach, payment application, credit creation, reconciliation, helped with end of month closing, lockbox, and adjustment processing
- Coordinated with a team of 5 to ensure accurate order fulfillment and resolution of discrepancies
- Conducted regular follow-ups with customers to address payment issues and resolve disputes
- Maintained detailed records of transactions and adjustments, ensuring financial accuracy and compliance
- Contributed to a 15% decrease in overdue accounts by optimizing invoicing and collection systems.
Education
High School Diploma - undefined
Denver Justice High School
Denver, CO01.2013
Skills
- Attention to detail
- Cash Handling
- Customer Service
- Workers' compensation
- Accounts receivable
- Time Management
Accomplishments
Created a successful petition with over 5M signatures.
Timeline
Accounts Receivable Specialist
ProEgg Inc.
11.2023 - Current
Accounts Receivable Specialist
University of Colorado Denver | Anschutz
01.2021 - 11.2023
Medical Records Specialist
Cornerstone Orthopedics and Sports Medicine/Orthopedic Centers of Colorado
09.2020 - 11.2020
Claims Coordinator
OrthoFi
05.2019 - 07.2020
Claims Processor
Anthem
09.2017 - 04.2019
Customer Service Rep
Anthem
05.2016 - 09.2017
High School Diploma - undefined
Denver Justice High School
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