Dawanda Lamerson
Baton Rouge
Summary
Detail-oriented oncology claims analyst with extensive experience in managing drug authorizations and coding for transplant and cellular therapy services. Proven track record of reducing claim denials and enhancing patient satisfaction through effective revenue cycle management and compliance monitoring.
Overview
26
26
years of professional experience
1
1
Certification
Work History
Oncology Claims Analyst 1
Our Lady of The Lake
Baton Rouge
11.2024 - Current
- Managed drug authorizations, edit and denial coding work queues for inpatient, outpatient, and hospital-based infusion for the transplant and cellular therapy department, and provided coding and reimbursement feedback for transplant and cellular therapy services.
- Ensured provider and facility contracts with payers for transplant and cellular therapy services, facilitating access for patients.
- Educated patients about benefits and financial responsibilities during consultations.
- Developed standard operating procedures for obtaining authorizations in the transplant and cellular therapy department.
- Initiated standard contract agreements between the facility and payors for transplant and cellular therapy services.
- Conducted training sessions for new and current employees on transplant and cellular therapy policies.
- Conducted weekly revenue cycle meetings with leadership to align patient care with financial sustainability.
- Work closely with providers and other clinical staff to ensure that coding is up to date for all services and diagnoses.
- Work with other departments to ensure that reimbursement issues are resolved, claim edits and assure clean claim submission.
- Monitored and evaluated compliance with documentation standards to identify trends, issues, and risk areas.
- Collaborated with national oncology institutions and clinical staff to ensure coding compliance and optimize reimbursement for clinical trials and off-label treatments.
Patient Financial Counselor
Mary Bird Perkins Cancer Center
Baton Rouge
12.2021 - 06.2024
- Conducted initial consultations with patients and families to clarify financial responsibilities and outline payment options.
- Informed patients of payment policies and coordinated arrangements for financial assistance.
- Followed up with patients to ensure accurate and up-to-date demographics, insurance information, and payment options.
- Obtains & verifies all demographic information for patients.
- Ensures authorizations are obtained before treatment.
- Documented and organized patient information in the system, ensuring accuracy and accessibility of records.
- Work on initial eligibility denials.
- Register all patients in our billing system, scan all outside physician orders in document management MT system and maintain our lab denial portal.
- Trained new hires on all utilized systems.
Patient Financial Counselor
American Oncology Network
Baton Rouge
07.2019 - 11.2021
- Managed collection of patient balances, resolved denials, and conducted account audits.
- Monitored and collected patient financial responsibilities to ensure timely payments.
- Reviewed treatment guidelines and monitored patient balances to ensure compliance.
- Updated patients' insurance benefits in OncoEMR and Centricity.
Insurance Collector
Comprehensive Pain Management
Baton Rouge
11.2016 - 09.2018
- Called insurance companies to resolve account issues and payments for medical claims, researching and appealing denied claims to ensure timely resolution.
- Maintained company's AR under 15% for claims billed over 90 days.
- I resolve patient issues with their billing and insurance questions.
- Managed accounts for all self-pay patients to ensure accurate billing.
- I qualify patients for our self-pay program and cash-pay program.
- Submit hardcopy claims to secondary payers that don't accept electronic payments.
- I contact patients in regards to their upcoming appointments and outstanding balances.
- My duties as a financial counselor are to verify that patient demographics and insurance information are current.
- Reviewed and authorized patient statements, ensuring accuracy and compliance with regulations.
Patient Access Rep
Our Lady of the Lake
Baton Rouge
09.2015 - 11.2016
- Contacts insurance providers to verify coverage and obtain authorization for service.
- Collected and documented patient information regarding services needed, insurance availability, and financial status to facilitate efficient admissions.
- Collected deductibles and co-pays from patients.
- Completes admissions and insurance forms.
- Developed understanding of healthcare administration concepts and practices to enhance service delivery.
- Followed established guidelines to ensure compliance and accuracy in task completion.
AR Coordinator
Amedisys Home Health
Baton Rouge
02.2010 - 05.2012
- Processed claims for Medicare, Blue Cross, and other insurance providers, ensuring accurate billing and timely payments.
- Verified insurance information and confirmed accuracy of extracted data, facilitating efficient claim processing.
- Managed billing, collection, and reimbursement processes, ensuring timely resolution of patient inquiries.
Insurance Assistant/Medical Office Specialist
North Oaks Health Systems
Hammond
07.2006 - 11.2009
- Greeted patients, answered telephones, scheduled appointments, verified insurance information, collected payments, prepared charts, and checked patients out of clinic, enhancing patient experience and office efficiency.
- Managed billing, collection, and reimbursement processes to ensure timely patient inquiries.
- Established and managed workman's compensation and industrial accounts for clinic system, ensuring compliance and accuracy.
- Tracked productivity, calculated total charges on multipage claims, compared against line items, and cross-trained on new functions to assist with claims processing.
- Confirmed that all data extracted was correct and complete for the claim to process, maintaining accurate and consistent reporting of work.
Photo Lab Manager
Walgreens
Hammond
09.2000 - 07.2006
- Managed daily lab operations, operated photo lab equipment, and supervised department employees.
- Managed photo lab operations and ensured efficient workflow among staff.
- Trained team members on photo processing techniques and equipment usage.
- Oversaw inventory management for photo supplies and equipment maintenance.
Education
High School Diploma -
Zachary High School
Zachary, LA05-1997
Associate of Science - Criminal Justice
Southeastern Louisiana University
Hammond, LA04-2026
Skills
- ICD-10
- ICD-9
- CPT coding
- Medical billing
- Claims processing
- Insurance Verification
- Medical coding
- Medical terminology
- Medicare
- Revenue cycle
- Managed care
- EMR systems
- Medical records
- Hospital skills
- Primary care
- Medical scheduling
- Medical collection
- Data analysis
- Financial auditing
- Time management
- Intake
- Windows
- Microsoft Office
- Computer skills
- Computer literacy
- Typing
- Clerical experience
- Vital signs
- Urinalysis
- Customer service
- Phone etiquette
- Medical office skills
- Medical receptionist
- Organizational skills
- Effective communication
- Supervisory skills
- NCQA standards
- Insurance claims
- Medical receptionist
- CPT coding
Certification
Driver's License, 007026534, 11/01/23, 11/01/27
Timeline
Oncology Claims Analyst 1
Our Lady of The Lake
11.2024 - Current
Patient Financial Counselor
Mary Bird Perkins Cancer Center
12.2021 - 06.2024
Patient Financial Counselor
American Oncology Network
07.2019 - 11.2021
Insurance Collector
Comprehensive Pain Management
11.2016 - 09.2018
Patient Access Rep
Our Lady of the Lake
09.2015 - 11.2016
AR Coordinator
Amedisys Home Health
02.2010 - 05.2012
Insurance Assistant/Medical Office Specialist
North Oaks Health Systems
07.2006 - 11.2009
Photo Lab Manager
Walgreens
09.2000 - 07.2006
High School Diploma -
Zachary High School
Associate of Science - Criminal Justice
Southeastern Louisiana University