Aleasha Lomas

• Use variety of learning modalities and support materials to facilitate learning process and accentuate presentations.
• Evaluate and revise lesson plans and course content to achieve student-centered learning.
• Transition course material and applied technological options for online and course-related software for Medical Coding and Integrated Medical Office Software.
• Developed and implemented Integrated Medical Office Software curriculum for improved learning and student performance.
• Grade quizzes, tests, homework and projects to provide students with timely academic progress information and feedback.
• Use exams, quizzes and assignments to assess student comprehension.

• Research CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
• Examine patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
• Prepare billing statements for patients and verified correct diagnostic coding.
• Review patient records, identify medical codes and create invoices for billing purposes.
• Precisely evaluate and verify benefits and eligibility.
• Post and adjust payments from insurance companies.
• Locate errors and promptly refile rejected claims.
• Evaluate patients' financial status and establish appropriate payment plans.
• Communicate with patients for unpaid claims for HMO, PPO and private accounts and deliver friendly follow-up calls for proper payments to contracts.
• Print and review monthly patient aging report and solicit overdue payments.
• Prepare accounts with past due balances and transfer those cases to collection agency.

• Developed new training programs such as online modules, interactive software, language labs and online programs and provided ongoing training to claims processors.
• Conducted orientation sessions to assess skill levels and areas of strength and weakness.
• Evaluated success of training programs and recommended improvements to upper management to enhance effectiveness.
• Devised comprehensive training courses and guided staff training by employing proven teaching methods.
• Developed curricula, instructions, documentation and written tests for claims training courses.
• Assisted in analyzing and assessing training and development needs for organizations, departments and individuals.
• Delivered group and individual training covering claims processing and new employee areas.
• Designed and facilitated training courses, aligning new learning development and solutions to organization's strategic goals, mission and vision.

• Assisted with reconciliations and customer communications.
• Worked with customers to answer questions, resolve disputes and research discrepancies.
• Supported customers with invoices, statements and other basic questions.
• Reviewed and balanced accounts within Epic.
• Resolved coordination of benefits discrepancies with payers.
• Interpreted correspondence to determine appropriate billing and payments.

• Managed household finances and schedules.
• Volunteered and participated in children's activities.

Multiple positions held within the 7 years employed with Premera Blue Cross:

Technical Support Specialist

• Helped merge support specialists and combined work between 4 teams to help share knowledge and level workload
• Participated in special handling development of policies and procedures to properly support the member and client.
• Removed barriers for turn around time and gaps within procedures.
• Performed daily, weekly and monthly claims audits followed by the opportunity to educate processors.
• Supported questions and additional training from teams as needed.

Team Lead III, and Acting Assistant Team Lead

• Daily workload management and scheduling.
• Managed 17 reports with included fostering development and HR management issues.
• Coached and mentored employees by conducting monthly one-on-one meetings and previous year reviews.
• Planned and implemented up-training and promotion opportunities.
• Understood and adhered to unique learning and interpretation styles of each employee.

Claims Associate IV and II

• Complex claims processing and adjustments.
• Special benefits application to claims processing.
• Continuous example of customer care and integrity.