Theresa McClelland
Cameron Park
Summary
Efficient Physician Billing Specialist known for high productivity and accurately completing billing tasks in fast-paced environments. Possess specialized skills in medical billing, claims processing, and compliance with healthcare regulations. Excel using critical thinking, problem-solving, and communication to navigate complex billing issues and enhance revenue cycle management.
Overview
33
33
years of professional experience
Work History
Medical Billing
Marshall Medical
Placerville
10.2012 - Current
- Processed and submitted claims accurately for various insurance providers.
- Communicated with healthcare providers to ensure accurate coding of services.
- Maintained updated knowledge of billing regulations and insurance policies.
- Collaborated with team members to streamline billing workflows and enhance efficiency.
- Generated invoices for services rendered by physicians and other healthcare providers.
- Analyzed and processed physician-biller requests for reimbursement from health plans.
- Corresponded with third party payers via phone calls or emails regarding claim resolution.
- Submitted appeals when necessary on denied or underpaid claims due to incorrect coding issues or missing documentation.
- Maintained detailed records of claim statuses including denials, appeals status, resubmissions and adjustments made on accounts receivable transactions.
- Assisted in training new employees on various aspects of the billing process.
- Participated in workshops, seminars, and training classes to gain stronger education in industry updates and federal regulations.
Co-Owner
McClelland Builders
Cameron Park
02.1993 - Current
- Managed office operations and ensured efficient workflow across departments.
- Assisted in budget preparation and monitored expenditures throughout the year.
- Performed data entry tasks into computer databases from paper documents.
- Maintained filing system for important documents such as contracts and invoices.
- Reconciled bank statements to ensure accurate financial records.
- Performed basic accounting, payroll and bookkeeping services to manage business operations.
- Prepared financial statements, including balance sheets, income statements, and statement of cash flows.
- Provided assistance in preparing tax returns annually.
- Managed payroll processing for staff members.
- Involved in all aspects of property acquisitions, marketing and sales.
Education
Some College (No Degree) - Business
Santa Rosa Junior College
Santa Rosa, California, CASkills
- Claim submission
- Medical billing
- Revenue cycle management
- Insurance verification
- Billing compliance
- Office management
Affiliations
have enrolled and taken part in many Medi-Cal / Medicare educational billing classes
Timeline
Medical Billing
Marshall Medical
10.2012 - Current
Co-Owner
McClelland Builders
02.1993 - Current
Some College (No Degree) - Business
Santa Rosa Junior College