Karalea Helzer, Cmbs, Cpc Email & Phone Number

Longmont, Co, Us

Aurora, Colorado, United States

Acting as the liaison for 260+ assigned providers/clinics/health systems for all things related to navigating Colorado Access. Ensuring providers adhere to care standards, billing and coding regulations, and federal/state laws. • Key stakeholder relationship building, communication, training and ensuring provider accountability/compliance.• Manage and resolve complex provider issues, including contracting, credentialing, claims, benefits, and billing for primary care and health system providers.• Subject matter expert for problem resolution with primary care and health system providers.

Colorado, United States

Led a team of nine staff to support 11 Practice Managers with developing a highly optimized records management and referral processing operation. Simultaneously performing work relating to supporting tasks for the regional director.• Root cause analysis of errors with the development of standardization of processes used to train and educate staff, resulting in increased revenue.• Knowledge, interpretation, and application of healthcare policies, practices, government regulations, and compliance practices.• Performed concurrent, internal, defensive, and stakeholder-requested account audits.• Conducted clinic and operation audits to ensure the accuracy of information and adherence to regulations.• Oversee recording of clinical billing to ensure proper accuracy and charge capture.• Facilitate communication between stakeholders to address discrepancies or concerns.• Proficient in financial management and attention to detail, ensuring the accuracy of financial transactions.• Analyzing various medical data to build reports for stakeholders.• Ensuring adherence to regulatory compliance and documentation practices to maintain accurate records and audit trails.

• Performs daily reconciliations of over the counter cash, and balancing of deposits and payment application• Account reviews regarding patient concerns, miss-applied payments, collections and refund review• Compiles data used to prepare financial, statistical and operational reports • Creates various reporting spreadsheets from various informational applications• Communicates with patients and peers to address inquiries and resolve challenges• Primary participant in the process reengineering project for Revenue Cycle management• Assisting with the current process mapping, development of potential solutions, analysis and implementation of changes made• Key in the development of the reconciliation process for ensuring accurate billing for all clinic physicians

Greeley, Co

• Tracked and posted revenue from various sources. • Compiled data for various reports and created reports for others to utilize.• Reconciliation of various accounts, entries, and ledger accounts.• Compilations of data from multiple sources to create tools and references for leadership.• Develop processes and workflows for the financial team.

Boulder, Co

• Preparation of invoices and posting payments for the sales team. • Created a workflow and process for a newly vacated role in which duties were unknown to department leads.• Performed revenue audits and reported findings to leadership, along with resolution ideas.

Greeley, Colorado

• Investigate and correct rejected and denied claims and re-bills within the timely filing limits• Reviewed confidential client demographic and make necessary corrections• Utilization of the CPT, HCPCS and ICD-9 manuals, along with teamwork brainstorming for resolutions to challenging patient encounters

Fort Morgan, Colorado

• Collect and compile monthly billing according to clinic and governing entities’ policies and procedures• Prepare billing from various source documents and transmit to the payer(s) via electronic submission• Investigate and correct rejected and denied claims and re-bills within the timely filing limits• Reviewed confidential client demographic and make necessary corrections• Utilization of the CPT, HCPCS and ICD-9 manuals, along with teamwork brainstorming for resolutions to challenging patient encounters• Reduction of A/R by greater than 53% over a five month period

Evans, Colorado

• Collect and compile monthly billing according to clinic and governing entities’ policies and procedures• Prepare state billing from various source documents and transmit to the state via electronic submission• Reconcile claims with payment received according to provider claim reports and a cash receipts records• Investigate and correct rejected and denied claims and re-bills within the timely filing limits• Reviewed confidential client demographic and program information data reports• Prepare monthly journal entries and adjusting journal entries• Ensure compliance with generally accepted accounting principles and company procedures• Review, investigate and correct errors and inconsistencies in financial entries, documents and reports• Print billing reports and use them as source documents for recording revenue in the accounts receivable ledger• Post payments from cash receipts data base, credit memos, and debit memos to accounts receivable subsidiary ledger

Greeley, Colorado

• Prepare monthly journal entries including, but not limited to payroll, fixed assets/depreciation, and prepaid expense adjustments• Reconcile balance sheet accounts• Analyze and prepare financial information to summarize and interpret current and projected company financial • Print and analyze general ledger reports to assist in budget development• Prepare budget spreadsheets for import to accounting software• Calculate proper allocation of approved budgeted expenses over 12 month period • Prepare departmental budget reference reports and notebooks

Loveland, Colorado

• Prepare monthly journal entries including, but not limited to fixed assets/depreciation, and prepaid expense adjustments• Reconcile balance sheet accounts• Print and analyze general ledger reports to assist in budget development• Prepare budget spreadsheets for import to accounting software• Calculate proper allocation of approved budgeted expenses over 12 month period • Prepare departmental budget reference reports