RoseMarie Hewitt
Aliquippa
Summary
Dynamic professional with extensive experience in accounts receivable management at Heritage Valley Health System. Achieved significant improvements in collection rates and efficient claims resolution. Expertise in data analysis and team development, promoting collaboration and enhancing process improvement. Dedicated to excellence in medical billing operations and regulatory compliance.
Overview
33
33
years of professional experience
Work History
Supervisor, Receivables Management
Heritage Valley Health System
Baden
06.2016 - Current
- Monitored accounts receivable reports weekly to ensure timely insurer payments.
- Reviewed claims for accuracy and completeness before submission.
- Conducted regular audits of medical billing activities to identify errors.
- Maintained up-to-date knowledge of CPT, HCPCS codes, Medicare regulations, and third-party requirements.
- Developed strategies to enhance collection rates while minimizing bad debt.
- Managed daily operations of medical billing team, including goal setting and task assignments.
- Analyzed payer reimbursement data trends, providing actionable recommendations for improvement.
Medical Biller Team Lead
Select Medical
Canonsburg
05.2001 - 06.2016
- Created monthly aging reports to identify delinquent accounts for review by management team.
- Performed daily reconciliation of accounts receivable with payment postings on the computer system.
- Provided training and support to new staff members regarding billing processes.
- Assisted with collection efforts as needed including contacting patients via phone, mail or email for collection of past due balances due to insurance denials or patient responsibility amounts owed.
- Performed follow up activities on unpaid claims with insurance companies or other third party payers by phone or written correspondence.
- Maintained accurate records of all billing activity in accordance with departmental standards.
- Assisted in auditing process by verifying accuracy of submitted claim forms against documentation provided by physicians' offices.
- Submitted electronic claims to various insurance carriers.
- Researched discrepancies between billed charges and payments received from insurance companies or other third party payers.
- Processed refunds requests timely and accurately according to established protocols.
- Reviewed patient insurance information to ensure accuracy and completeness of claims submission.
- Completed and submitted appeals for denied claims.
- Monitored reimbursement from managed care networks and insurance carriers to verify consistency with contract rates.
Claims Representative
Natiowide Insurance
Robinson
03.1997 - 09.2000
- Filed appeals on behalf of customers when necessary after denial of a claim due to insufficient evidence.
- Resolved complex discrepancies in policyholder files to facilitate accurate claim processing.
- Investigated facts, confirmed coverage and liability, negotiated settlements, and determined payments for claims.
- Maintained detailed records of all communication with customers, claimants, providers, and internal departments.
- Attended continuing education seminars related to insurance industry best practices and new legislation.
- Handled customer inquiries regarding insurance policy coverage details and payment status updates.
Medical Administrative Secretary
Abby Home Health
Uniontown
12.1991 - 03.1997
- Ordered office supplies and maintained inventory of all materials used in the office.
- Attended meetings as directed by supervisor or department head.
- Answered phone calls and responded to emails from patients regarding their inquiries.
- Organized patient charts for easy access when needed.
- Handled confidential documents in accordance with HIPAA regulations.
- Managed incoming and outgoing mailings related to medical records requests or other correspondence between providers and insurance companies.
- Verified insurance eligibility prior to services rendered.
- Performed data entry tasks into electronic medical record systems.
- Prepared documents such as letters, memos, reports, spreadsheets, charts, graphs and presentations.
Education
Associate of Arts - MEDICAL BILLING/BUSINESS
WEST VIRGINIA CAREER COLLEGE
Lemont Furnace, PA06-1989
Skills
- Accounts receivable management
- Claim resolution and review
- Medical billing expertise
- Training and development
- Regulatory compliance
- Data analysis and reporting
- Time management
- Process improvement
- Project management
- Staff management
- Team building
- Employee development
- Conflict resolution
Experian Clearinghouse
- Implemented new clearinghouse as Project Coordinator getting system set up and having staff trained.
- Set weekly meetings to trouble shoot or discuss questions or issues while transitioning to new system.
Timeline
Supervisor, Receivables Management
Heritage Valley Health System
06.2016 - Current
Medical Biller Team Lead
Select Medical
05.2001 - 06.2016
Claims Representative
Natiowide Insurance
03.1997 - 09.2000
Medical Administrative Secretary
Abby Home Health
12.1991 - 03.1997
Associate of Arts - MEDICAL BILLING/BUSINESS
WEST VIRGINIA CAREER COLLEGE
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