Summary
Overview
Work History
Education
Skills
Accomplishments
Interests
Work Availability
Work Preference
Software
Languages
Timeline
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Amy Lilly

Amy Lilly

Rochester,NH

Summary

Highly experienced and efficient Medical Office Administrator with 30 years of expertise in medical billing, prior authorizations, and customer service. Proficient in EMR systems, ICD-10, and CPT coding. Track record of managing high-volume billing queues, resolving complex claim denials, and providing exceptional patient and provider support. Recognized for team supervision, new staff training, and driving process improvements. Solid background in medical office operations, hospice care, and senior care settings. Diligent supervisor overseeing medical billing operations to ensure accuracy in claims processing, streamline procedures, and reduce errors. Demonstrated proficiency in managing complex billing systems and resolving discrepancies. Dynamic individual with hands-on experience in RCM, possessing strong problem-solving skills and a proactive approach to new tasks. Known for adaptability, creativity, and a results-oriented mindset while committed to making meaningful contributions and advancing organizational goals.

Overview

30
30
years of professional experience

Work History

Medical Billing Supervisor

SportsMedicine Atlantic Orthopaedics
01.2025 - 07.2025
  • Managed a team of 6 medical billing specialists, providing guidance and support to ensure accurate and timely submission of claims
  • Developed and maintained relationships with insurance companies to resolve billing issues and expedite payment processing
  • Oversaw the reconciliation of accounts receivable, identifying discrepancies and taking appropriate actions for resolution
  • Collaborated with physicians and healthcare providers to address any documentation or coding errors that impacted reimbursement rates
  • Monitored key performance indicators (KPIs) such as average days in accounts receivable (AR) to identify areas for improvement
  • Led regular team meetings to discuss updates on industry regulations, changes in coding practices, and best practices for efficient billing processes
  • Developed strategies to optimize revenue cycle management by reducing claim rejections through improved documentation accuracy

Physician Billing Specialist

Catholic Medical Center
06.2023 - 12.2024
  • Handle daily electronic billing work queues and manage paper claims submissions by addressing payer edits and ensuring seamless claims transmission to clearing houses or third-party payers.
  • Maintain comprehensive documentation of billing activities, ensuring strict compliance with relevant billing regulations for assigned payers. Any concerns regarding compliance or billing irregularities will be promptly escalated to department leaders.
  • Identify and rectify claim denials received via Explanation of Benefits (EOB), denial reports, or correspondence from insurance carriers. Take necessary actions, including initiating adjustments or appeals, to resolve denials effectively.
  • Conduct thorough follow-ups on unresolved open accounts, documenting reasons for reimbursement delays and actions taken within the electronic billing system.
  • Keep a close eye on workload for aging inventories and ensure timely filing.
  • Additionally, display exceptional customer service skills by promptly addressing inquiries and billing concerns from patients, internal associates, and third parties in a professional and efficient manner.
  • Support Team Lead with training/education to new hires
  • Provide assistance when needed to other departments for large RCM projects that need to be addressed.

Medical Billing Coordinator

Cornerstone VNA
07.2021 - 06.2023
  • Assist Intake after admissions for accuracy of payer and patient information. Obtain initial and follow-up authorizations for commercial EDS/Medicare/insurances for eligibility purposes. Review and submit Medicare, Medicaid and commercial insurance claims either electronically or manually. Participate in month-end billing verification. Monitor and follow-up on collections for delinquent accounts. Provides status reports of accounts receivable to the Billing Manager. Work independently and am meticulous in achieving accuracy and attention to detail. Review and monitor self pay accounts - Communicate and work with patients on outstanding accounts -

Prior Authorization Specialist

Atlantic Digestive Specialists
11.2020 - 07.2021
  • Medical billing and prior authorization. Communication with New Hampshire health plans. Uphold billing principles, authorization requirements, coding, charge entry, payment posting, and claims follow up. Be organized, detail oriented, self-motivated and possess a positive attitude. Update patient accounts and process patient payments, online and in person.
  • Review and update clinical staff on patient schedules and insurance coverage.
  • Receive and distribute incoming patient call.
  • Assist in all office duties

Department Lead

Kohls
09.2020 - 11.2020
  • Oversee operations team of 30 employees and delivery of excellent customer service aligned with Kohl's "Yes We Can" culture
  • Manage the inventory ordering and stocking of over 700k SKUs to meet in-store and online demand
  • Utilized Kohl's tools and technology to plan, communicate and share information
  • Manage department organization of inventory and customer service excellence
  • Provide support in all departments
  • Receive and process freight and distribute to proper departments

Operations Lead

KOHLS
07.2020 - 09.2020
  • Oversaw operations team of 30 employees the delivery of excellent customer service aligned with Kohl's "Yes We Can" culture
  • Manage the inventory ordering and stocking of over 700k SKUs to meet in-store and online demand
  • Utilized Kohl's tools and technology to plan, communicate and share information
  • Seasonal Sales Associate November 2018 - February 2020
  • Assisted in-store customers with item inquiries and credit card applications
  • Met daily sales goals of $25,000 and often exceeded them by 15%
  • Corona, CA

Home Infusion Account Manager / Records Specialist

AMERITA INC
11.2017 - 03.2019
  • Implemented a structured report linking proper billing codes and with supporting diagnoses from treating physicians to recover $500K in outstanding debt from claims appeals
  • Created / implemented training portal for records department to train 9 employees
  • Built strong business relationships with 30+ account representatives overseeing $2.3M+ in yearly sales

Executive Administrator

LEOMO LLC
05.2017 - 11.2017
  • Managed the calendars and schedule of 5 staff members
  • Relocated online web portal to build new client base
  • Managed $300k in accounts, ensuring all issues are addressed

Hospice Community Account Liaison

BERKLEY HOME HEALTHCARE
11.2016 - 01.2017
  • Meet with 20 accounts and pull in 3 or more referrals-
  • 100 accounts overseen monthly
  • Cultivate and maintain 20-25 new accounts monthly

Community Support Specialist

Springwood Retirement Community
06.2016 - 11.2016
  • Provided engaging property tours for prospective residences and family members, highlighting services and amenities to help increase customer acquisition rate and revenue by 60%
  • Oversaw an average of 15-20 units, providing key services and activities to residences

Administration Specialist

Several different companies
02.2012 - 11.2016
  • SCLHS – Project Manager / Cash Control Supervisor
  • BATH & BODY WORKS – Sales Lead
  • SELF-EMPLOYED – Home Manager / Child Minder
  • FREEDOM OXYGEN/WALGREENS HOME CARE – Reimbursement Manager

Education

Some College - Medical

FRONT RANGE COMMUNITY COLLEGE
Range, CO
01.2014

Some College - Business Administration

COMMUNITY COLLEGE OF Aurora
Aurora, CO

High school diploma - General Studies

Rochester High School
Rochester, MI
05.1990

Skills

  • Proficient in EMR software
  • Proficient in ICD-10 classification
  • Personalized home support
  • HIPAA compliance knowledge
  • Accounts receivable management
  • Quality assurance in documentation
  • Home Health
  • Advanced Excel skills
  • Reception management
  • EHR systems
  • Service excellence
  • Revenue cycle optimization
  • Comprehensive case coordination
  • CPT code proficiency
  • Dental Receptionist
  • ICD-9
  • Anatomy Knowledge
  • Typing (10 years)
  • Computer literacy
  • Experience in staff supervision
  • Trizetto (1 year)
  • Insurance Verification
  • Account Management
  • Mod Med (1 year)
  • HCPCS
  • Microsoft Word
  • Federal Information Processing Standards (10 years)
  • Medical Office Experience (10 years)
  • Recruiting
  • Physiology knowledge
  • Personal Assistant Experience
  • Social Media Management (10 years)
  • Employee Orientation

Accomplishments

  • Supervised team of 6 staff members.
  • Documented and resolved outstanding A/R tied to patient accounts which led to sending over 800 accounts totaling just over $500K to collections.
  • Achieved a 50% increase in revenue through effectively helping with reviewing untouched workman's compensation accounts and getting them processed out the door in a more timely manner.


Interests

  • Exploring famous landmarks, historical sites, and cultural attractions in a new destination
  • Food Tourism
  • Enjoying the art of baking and pastry-making, experimenting with recipes
  • Learning new cooking techniques and expanding my culinary skills

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference

Work Type

Full Time

Work Location

On-SiteRemoteHybrid

Important To Me

Work-life balanceCompany Culture401k matchStock Options / Equity / Profit SharingCareer advancement

Software

Modernizing Medicine

TriZetto

Fin Thrive

ESummit

Epic

BrightTree

Sage

People Soft

Sunrise

Encoder Pro

Languages

English
Native or Bilingual

Timeline

Medical Billing Supervisor

SportsMedicine Atlantic Orthopaedics
01.2025 - 07.2025

Physician Billing Specialist

Catholic Medical Center
06.2023 - 12.2024

Medical Billing Coordinator

Cornerstone VNA
07.2021 - 06.2023

Prior Authorization Specialist

Atlantic Digestive Specialists
11.2020 - 07.2021

Department Lead

Kohls
09.2020 - 11.2020

Operations Lead

KOHLS
07.2020 - 09.2020

Home Infusion Account Manager / Records Specialist

AMERITA INC
11.2017 - 03.2019

Executive Administrator

LEOMO LLC
05.2017 - 11.2017

Hospice Community Account Liaison

BERKLEY HOME HEALTHCARE
11.2016 - 01.2017

Community Support Specialist

Springwood Retirement Community
06.2016 - 11.2016

Administration Specialist

Several different companies
02.2012 - 11.2016

Some College - Business Administration

COMMUNITY COLLEGE OF Aurora

High school diploma - General Studies

Rochester High School

Some College - Medical

FRONT RANGE COMMUNITY COLLEGE