Rachel Simpson
Denver
Summary
Motivated medical billing and coding specialist with over 15 years of experience in health operations management, billing, and pharmacy processing. Strong organizational, communication, and problem-solving skills, with attention to detail. Time-management skills and ability to work with a team. Microsoft Word, PowerPoint, Data Analysis, and Internet Research
Overview
21
21
years of professional experience
Work History
Revenue Cycle Specialists Supervisor
Eating Recovery Center
01.2022 - 02.2025
- Provided guidance and direction to subordinates regarding job duties and responsibilities.
- Monitored employee productivity to provide constructive feedback and coaching.
- Reviewed and verified insurance claims for accuracy and compliance.
- Assisted patients in understanding their insurance benefits and payment options.
- Implemented workflow improvements to enhance revenue cycle efficiency.
- Trained new staff on policies, procedures, and system usage.
- Researched discrepancies on unpaid invoices and reconciled them.
- Compiled data into weekly and monthly reports outlining performance metrics related to revenue cycle activities.
- Identified areas where process improvements can be made within the revenue cycle.
- Prepared financial statements for management review.
- Trained new employees on best practices and company policies.
- Facilitated team meetings to discuss patient needs and staff concerns.
Revenue Cycle Specialists Levels 1-2-3
Eating Recovery Center
03.2019 - 01.2022
- Collaborated with clinical staff to gather necessary documentation for claims.
- Collaborated with other departments to resolve customer inquiries regarding billing issues.
- Managed patient billing processes to ensure timely reimbursements.
- Coordinated with insurance companies for claim submissions and follow-ups.
- Reviewed patient accounts for accuracy and compliance with regulations.
- Assisted in resolving billing disputes to maintain patient satisfaction.
- Supported auditing processes by providing documentation and information as needed.
- Processed appeals related to denied or rejected claims in a timely manner.
- Contacted insurance providers to check patient coverage.
- Audited payments from third-party payers to ensure accuracy of reimbursement amounts.
- Researched discrepancies on unpaid invoices and reconciled them.
- Ensured all regulatory requirements were met when submitting claims for payment.
- Maintained current knowledge of insurance policies, procedures, regulations, and guidelines.
- Reached out to responsible companies and individuals to collect on outstanding debts.
- Monitored accounts receivables daily to determine appropriate follow-up action needed.
- Identified and corrected payment problems involving patients or third-party payers.
Billing Specialist/New Patient Coordinator
Omnicare Long Term Care Pharmacy
08.2012 - 11.2017
- Assisted in ordering, purchasing, and inventory process of pharmaceuticals and supplies
- Implemented billing procedures and trained new employees
- Established and maintained patient profiles and charts, effect in organization matters
- Ensures work is performed accurately and efficiently, excellent time management skills.
- Efficient in fast-paced Environment and High Volume Claims. Met Goals of exceeding 5000 claims monthly.
- Oversaw online payment and invoicing procedures
- Gathered all necessary information for Intake Admission for all new and readmits to our facilities
- Initiated Prior Authorizations with the Insurance Plans
- Researched and Resolved Billing Discrepancies
- Perform routine medical record audits to comply with insurance company requirements.
- Worked Directly with Central Billing Center in processing of Guarantor End of Cycle Billing.
- Provided exceptional customer service and ensuring all clients knew status of accounts
- Resolved re-billed and un-billed charges.
- Medicare, Medicaid, Hospice, and Private Plan Prescription Processing
- Uphold and reinforced compliance with hospital policies and federal regulations such as HIPAA.
- Lead compounder
- Managed inventory of supplies, equipment, and prescriptions
- Billed Insurances
- Interacted with customers and took payments
- Processed billing statements for long-term care pharmacy services.
- Reviewed patient accounts for accuracy and completeness.
- Coordinated with healthcare providers for billing inquiries.
- Maintained electronic records in pharmacy management systems.
- Assisted in resolving discrepancies related to claims submissions.
- Supported audits by providing necessary documentation and reports.
- Provided prompt and accurate services through knowledge of government regulations, health benefits and healthcare terminology.
Certified Tech
Pharmaca Integrative Pharmacy
02.2010 - 04.2012
- Lead compounder
- Managed inventory of supplies, equipment, and prescriptions
- Billed Insurances
- Interacted with customers and took payments
- Lead Trainer for new hires
- Transmitted new orders from doctors to the system
- Assembled patients' profile and prescriptions
Certified Tech
Kroger Pharmacy
10.2003 - 02.2010
- Lead Trainer for new hires
- Assembled patients' profile and prescriptions
- Assisted pharmacists in preparing and dispensing prescriptions efficiently.
- Maintained accurate inventory levels for pharmacy supplies and medications.
Education
B.A. - Business Administration and Marketing
Middle Tennessee State University
05.2009
Skills
- Medical billing
- Coding
- Health operations management
- Billing
- Pharmacy processing
- Organizational skills
- Communication skills
- Problem-solving skills
- Attention to detail
- Time-management skills
- Teamwork
- Microsoft Word
- PowerPoint
- Data Analysis
- Internet Research
Timeline
Revenue Cycle Specialists Supervisor
Eating Recovery Center
01.2022 - 02.2025
Revenue Cycle Specialists Levels 1-2-3
Eating Recovery Center
03.2019 - 01.2022
Billing Specialist/New Patient Coordinator
Omnicare Long Term Care Pharmacy
08.2012 - 11.2017
Certified Tech
Pharmaca Integrative Pharmacy
02.2010 - 04.2012
Certified Tech
Kroger Pharmacy
10.2003 - 02.2010
B.A. - Business Administration and Marketing
Middle Tennessee State University