CATHLEEN MENEFEE-DALL
Shasta Lake,CA
Summary
Results-oriented Patient Account Representative IV with expertise in claims processing, appeals management, and HIPAA compliance. Proven ability to enhance revenue recovery through strategic analysis and relationship building with insurance providers.
Overview
15
15
years of professional experience
Work History
Patient Account Representative IV
Stanford Health Care
Stanford, CA
12.2017 - Current
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies collecting consistently over $800,000 per year.
- Analyzed trends in unpaid accounts and devised targeted solutions for enhanced revenue recovery.
- Exhibited adaptability in navigating intricate payer guidelines to optimize reimbursement opportunities.
- Cultivated strategic relationships with key contacts at insurance companies to facilitate prompt resolution of claims disputes.
- Oversaw high-volume medical claims processing by prioritizing tasks according to due dates and urgency averaging over 60 claims per day .
- Ensured confidentiality of sensitive patient date while adhering to HIPAA regulations.
- Assisted colleagues during peak periods or absences, showcasing teamwork skills while maintaining personal workload demands efficiently.
Insurance Follow-Up Analyst
University Healthcare Alliance
Newark, CA
10.2015 - 12.2017
- Analyzed healthcare data to identify trends and inform decision-making processes.
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted approximately 50-55 claims per day.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Assisted with payment posting and refunds.
- Fostered a positive work environment through active participation in team meetings and contribution of innovative process improvement ideas.
Billing Specialist
Tethys Bioscience (Contractor)
Tracy, CA
10.2013 - 10.2015
- Processed and reviewed billing statements for accuracy and compliance with company policies billing over 3500 statements per month.
- Collaborated with cross-functional teams to resolve billing discrepancies and improve customer satisfaction.
- Implemented automated invoicing procedures to enhance efficiency and reduce processing time.
- Addressed customer inquires related to billing discrepancies, delivering clear resolutions.
- Established and upheld comprehensive transaction records to ensure adherence to company policies and regulations.
Billing Specialist
Kelly Services
Pleasanton, CA
07.2011 - 10.2013
- Analyzed billing data to identify trends and recommend improvements for operational workflows.
- Managed claim denial and appeal processes with confidence and expertise.
- Spearheaded collaboration with healthcare team to ensure precise application of billing codes.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Located errors and promptly refiled rejected claims processing on average 40-45 claims per day including appeals.
- Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
Education
Certificate of Completion - Medical Billing And Coding
San Joaquin Valley College
Visalia, CA11.2010
Skills
- EPIC Software
- Microsoft Office
- Verbal and written communication
- Medical terminology
- HIPAA compliance
- Decision-making
- Payor portals
- Problem-solving
Timeline
Patient Account Representative IV
Stanford Health Care
12.2017 - Current
Insurance Follow-Up Analyst
University Healthcare Alliance
10.2015 - 12.2017
Billing Specialist
Tethys Bioscience (Contractor)
10.2013 - 10.2015
Billing Specialist
Kelly Services
07.2011 - 10.2013
Certificate of Completion - Medical Billing And Coding
San Joaquin Valley College
4 Time Employee of the Month
UHA - Awarded 4 months after hire out of over 100 employees.
SHC - 3 time teams award out of 28 employees.