April Lindsay
Charlotte,NC
Summary
Skillfully assessed operational procedures, providing hands-on experience analyzing records and investigating complex troubleshooting issues. Accomplished expert navigating latest compliance regulations and service-level agreements, maintaining strict compliance with updated standards.
Overview
8
8
years of professional experience
Work History
Revenue Cycle Analyst
Abs Kids
03.2024 - Current
- Collects data from multiple sources as needed and can determine how to unify into a single data set when needed to complete necessary analyses
- Analyzes data for insights into the denials management operations business, and for special prevention and denials management projects. This includes identifying denial trends by root cause, payor related issues, physician trends, etc.
- Reports on daily operational statistics as requested by leadership (Supervisors, Managers, and Directors), key findings, insights and recommendations to respective counterparts and plays an active role if requested in any and all A/R Management, Billing, and Denials Management related group forums
- Spearheads denials management prevention projects by gathering and analyzing data needed to support process improvement
- Develops and maintains department dashboards and distributes reports to appropriate audiences. This includes departmental KPIs and reports, executive dashboards, staff productivity and quality reports, etc.
- Design, prepare, modify, and develop selected recurring and ad-hoc revenue cycle reports within given projects
- Conduct research and ad-hoc analysis to support portfolio and project goals
- Quickly identify business needs based on a proposed issue and assess its overall impact to revenue cycle.
- Identify, distinguish, and analyze multiple components of a problem, and then make recommendations for business change
- Provide thorough recommendations based on analyses to our project teams and stakeholders to support strategic decision-making
- Review, process, and analyze large amounts of information related to the revenue cycle
- Document project needs as they relate to business requirements, test case planning, and other project artifacts
- Manage and facilitate quality assurance validation efforts
- Participate in the development of training materials and assist in project closures, as needed.
Billing Specialist (Contract)
Caremetx
12.2023 - 03.2024
- Collects and reviews all patient insurance benefit information, to the degree authorized by the SOP of the program.
- Provides assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications.
- Completes and submits all necessary insurance forms in a timely manner as required by all third party payors for prior authorizations. Tracks and follow up on prior authorization request.
- Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.
- Maintains frequent phone contact with provider representatives, third party customer service representatives, and pharmacy staff.
- Reports any reimbursement trends/delays to supervisor.
- Processes any necessary insurance/patient correspondence.
- Provides all necessary documentation required to expedite prior authorization request. This includes demographic, authorization/referrals, National Provider Identification (NPI) number, and referring physicians.
- Coordinates with inter-departmental associates as necessary.
PROGRAM SPECIALIST
AGDATA
05.2023 - 12.2023
- Create and test program calculations in the program calculation tool in conjunction with customer-specific requirements of program development and validation
- Adhere to program management processes and documentation, perform basic SQL queries and analysis, review data, create reports
- Coordinate and track tasks, deliverables and client communication
- Research issues and create solutions.
OPERATIONS ANALYST/PROJECT MANAGEMENT
Cleared4
02.2022 - 04.2023
- Managing accounts receivables and accounts payables and tracking/following up on past due receivables and collections efforts
- Preparing vendor registration applications and online forms for registration as a vendor with company's customers
- Tracking weekly KPIs for company organization, and other operational reporting tasks as assigned by the CFO, President, or CEO
- Obtained and complete customer contract term sheets to support needs of accounting, legal, and audit functions
- Preparing financial reports by collecting, analyzing, and summarizing account information and trends as requested, in a timely and accurate fashion.
- Performing ad hoc assignments and financial analysis as needed.
- Implemented SQL to retrieve data reports.
- Identified plans and resources required to meet project goals and objectives.
- Modified and directed project plans to meet organizational needs using SaaS software.
- Liaison reports and projects between departments.
- Respond to SOP process/inquires
- Developed and implemented strategic project plans to meet business objectives using Agile system.
TEAM LEAD
Elixir Solutions
08.2020 - 02.2022
- Assist staff with resolving issues from members, providers and pharmacies
- Respond to calls for members about co-pays, deductibles and co-insurance
- Documenting information and reporting to supervisor
- Utilize multiple company database programs for accessing member information
- Established open and professional relationships with team members to achieve quick resolutions for various issues
- Take notes and follow-up with tasks from meetings
- Prepared detailed reports on updates to project specifications, progress, identified conflicts and team activities
- Coached team members in techniques necessary to complete job tasks.
PROGRAM ELIGIBILITY SPECIALIST
Conduent/USAC
07.2019 - 08.2020
- Review eligibility cases meeting all production and quality goals
- Monitor and assess individual/group performance against established standards/requirements
- Provide feedback to the leadership team and assist in addressing education/training needs with Project Director, Managers and Supervisors including preparing summaries and presentations when appropriate
- Participate in and contribute to the quality improvement process
- Support Eligibility with the processing of Cases
- Conduct grievance and complaint investigation, documentation, and resolution activities in accordance with approved policies and procedures
- Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.
CUSTOMER SERVICE REPRESENTATIVE
Conduent/Sprint
06.2018 - 07.2019
- Used company troubleshooting resolution tree to evaluate technical problems while leveraging personal expertise to find appropriate solutions.
- Created help desk tickets, troubleshot and resolved desktop issues.
- Provided Tier 1 IT support to non-technical internal users through desk side support services
- Collaborated with supervisors to escalate and address customer inquiries or technical issues
- Conducted in-depth product and issue resolution research to address customer concerns.
DIETARY AIDE LEAD
Mint Hill Senior Living
10.2016 - 05.2018
- Assists with food preparation in accordance with our established procedural guidelines, and as may be directed by the Dietary Manager or supervisor
- Follows facility procedure for storing, serving and transporting food and supplies
- Offers menu substitutions and records them in accordance with procedural guidelines
- Communicates well with patients/residents/clients and family members providing warm and friendly greeting and an approachable attitude to families, visitors, patients/residents/clients and responds to expressed concerns while displaying a helpful, caring demeanor
- Responsible for patient meal set up, including reviewing patients' dietary orders for accuracy and diet compliance.
Education
Associate of Science - Computer Programming
York Technical College
Rock Hill SC04.2026
High School Diploma -
Lancaster High School
Lancaster, SC05.2014
Skills
- Problem-Solving
- Data Visualization
- Special Projects
- Data Process
- Reporting
- Data Analysis
- Workflow Improvements
- Strategic planning
- Forecasting and Planning
Timeline
Revenue Cycle Analyst
Abs Kids
03.2024 - Current
Billing Specialist (Contract)
Caremetx
12.2023 - 03.2024
PROGRAM SPECIALIST
AGDATA
05.2023 - 12.2023
OPERATIONS ANALYST/PROJECT MANAGEMENT
Cleared4
02.2022 - 04.2023
TEAM LEAD
Elixir Solutions
08.2020 - 02.2022
PROGRAM ELIGIBILITY SPECIALIST
Conduent/USAC
07.2019 - 08.2020
CUSTOMER SERVICE REPRESENTATIVE
Conduent/Sprint
06.2018 - 07.2019
DIETARY AIDE LEAD
Mint Hill Senior Living
10.2016 - 05.2018
Associate of Science - Computer Programming
York Technical College
High School Diploma -
Lancaster High School