ROBIN L. COPPLE
Tollhouse
Summary
Dedicated and skilled billing and claims processing professional with experience in Medical Billing for inpatient and outpatient claims. Expert skills in the full scope of revenue cycle management.
Overview
31
31
years of professional experience
1
1
Certification
Work History
Account Representative II
RBS Inc.
06.2019 - Current
- Resolve eligibility denials on patient accounts by updating and correcting insurance information and refiling claims
- Review claim denials, file appeals when necessary for non payment, correct cpt/icd10 errors and refile claims hard copy or electronically for commercial and government payers.
- Resolve account balances by posting payments or transferring patient responsibility balances.
- Identify error trends and worked with management to implement solution strategies
Accounts Receivables Specialist/Medical Biller
McKesson/Change Healthcare
09.2017 - 06.2019
- Resolve billing issues by correcting errors and rebilling claims for Commercial/Government payers
- Reconcile and resolve Accounts Receivables issues by following up on outstanding claim balances
- Identified billing error trends and coordinated with management to implement solutions
- Conduct thorough research addressing patient and insurance company issues
- Complete high-volume claims filing ensuring accurate coding
- Aide in meeting daily department goals by decreasing days outstanding
Accounts Receivable Specialist
Regional Hand Center/Bennett Frost Staffing
11.2015 - 07.2016
- Provided account follow up for aged receivables accounts for large balances
- Submitted insurance claims and ensured correct payments on patient accounts for surgical cases
- Confirmed patient understanding of their account balance and financial obligations
- Established and maintained monthly payment plans in accordance to practice guidelines
Inpatient Resolution Specialist/Team Coordinator/CRCR
Vibra Healthcare
04.2009 - 03.2015
- Provided account follow up for aged receivables accounts for large balances
- Participated in management meetings and reviewed financial reports
- Assisted in interviewing candidates for new billing department employees
- Coordinated and monitored outpatient staff closely and provided training as needed
- Approved account adjustment requests and processed and approved refunds
- Resolved account balance and credit issues in a timely manner
- Coordinated with Government payers to resolve payment and contract issues
- Communicated daily with hospital staff and CFO's to work to resolve accounts
- Assisted patient account representatives to resolve account issues complying with regulations
- Performed high-volume electronic billing for primary and secondary claims
- Confirmed accounts were netted correctly according to facility contracts
- Managed appeals process for underpaid and unpaid claims and correspondence
- Collected payments from uninsured patients and verified patient insurance eligibility/benefits
Intake Examiner
The Zenith (Insurance Relief)
10.2008 - 12.2008
- Communicated for initial contact to employers, medical providers and injured employees
- Reviewed and uploaded medical documentation for work related injuries
- Entered treatment requests into database and organized documentation for supervisor review
Claims Processor
Cigna Healthcare
04.1999 - 04.2006
- Senior claims adjudicator for managed care portfolios for California, Oregon, Utah, Nevada, and Washington health plans
- Specialized in National Accounts and high-dollar contracts
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy
- Compared claim application and provider statement with contracted rates
- Facilitated team knowledge sessions including individualized training plans for employees
- Expert working knowledge of explanation of benefits and coverage of benefits
Customer Service for various companies
Olsten Temporary Services
08.1998 - 04.1999
- Provided front desk reception, customer service, filing, billing and inventory management
Customer Service Specialist
Jim Barr State Farm Insurance
08.1997 - 01.1998
- Managed multiple phone lines and scheduled appointments
- Verified insurance policies and answered customer inquiries
- Performed cash application duties including managing daily bank deposits and reconciliation
- Completed inventory management duties including ordering supplies and maintaining office supplies
Assistant Front Office Manager
Holiday Inn Centre Plaza
05.1994 - 07.1997
- Supervised all front desk clerks for assigned shift including reviewing daily time and attendance
- Coordinated with hotel to manage groups of guests up to two thousand people
- Completed reservation requests and operated PBX phone system for high-volume calls
- Managed inventory control for assigned shift ensuring adequate supplies
- Supervised cash drawer deposits more than $10,000 daily
- Served in role as Night Manager on duty for entire hotel responsible for all operations
Education
Medical Billing Certification Program -
Fresno City College
Fresno, CA01.2009
General Studies -
Fresno City College
Fresno, CA01.1989
Skills
- Customer Service Management
- Claims/Denial Management
- Microsoft Office Suite
- Employee Supervision/Time & Attendance
- Commercial/Government Insurance
- Trending Analysis
- Patient Collection
- Develop/Deliver Presentations
- Communication Skills/Phone
- Analytical Skills/Critical Thinking
- Workflow Analysis
- Eligibility/Benefits Verification
- Complex Administrative Support
- Medical Records Management
- Managed Care Insurance Guidelines
- Billing Timely Filing Regulations
- Inventory Management
- Leadership Skills/Office Management
- Electronic Billing Software
- Medical Terminology/EMR
- Statistical Skills
- Typing 52 WPM/Data Entry/10-key
- Accounts Receivables Management
- Reconciliation/Collections Procedures
- Prepare/Review Complex Correspondence
- Professional Development Training
- Report Preparation and Analysis
- Performance Improvement Analysis
- Process Improvement and Efficiency
- Staff Training and Development
- Patient Confidentiality/HIPAA Regulations
- Workers Compensation Knowledge
- Diversity Sensitivity
- Front Office Reception
- PBX Phone Systems
Certification
CRCR (Certified Revenue Cycle Representative), Vibra Healthcare, The Healthcare Financial Management Association's (HFMA) professional certification of front line staff including training in seven interrelated professional practice areas: Compliance, Patient Access, Claims Processing, Account Resolution, Financial Management, Revenue Cycle Departments Required Competencies
Timeline
Account Representative II
RBS Inc.
06.2019 - Current
Accounts Receivables Specialist/Medical Biller
McKesson/Change Healthcare
09.2017 - 06.2019
Accounts Receivable Specialist
Regional Hand Center/Bennett Frost Staffing
11.2015 - 07.2016
Inpatient Resolution Specialist/Team Coordinator/CRCR
Vibra Healthcare
04.2009 - 03.2015
Intake Examiner
The Zenith (Insurance Relief)
10.2008 - 12.2008
Claims Processor
Cigna Healthcare
04.1999 - 04.2006
Customer Service for various companies
Olsten Temporary Services
08.1998 - 04.1999
Customer Service Specialist
Jim Barr State Farm Insurance
08.1997 - 01.1998
Assistant Front Office Manager
Holiday Inn Centre Plaza
05.1994 - 07.1997
General Studies -
Fresno City College
Medical Billing Certification Program -
Fresno City College
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