Florida Lacy
Euless,United States
Summary
Energized by challenges, I excelled at Post Acute Medical LLC, mastering revenue cycle management and fostering effective team collaboration. Leveraging a detail-oriented mindset, I significantly enhanced billing accuracy and financial performance, achieving a 96% GPA in the AAPC program. My strategic organization and analytical problem-solving skills drive continuous improvement and success.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Sabbatical-
Pursued Additional Education
Euless, TX
04.2022 - 07.2024
- Grieved personal loss of multiple family members due to COVID-19.
- Achieved a 96% GPA in the AAPC program during my sabbatical.
- Refined career path after personal loss with strategic planning.
- Maintained updated knowledge through continuing education and advanced training.
Clinical Appeals Coordinator
Post Acute Medical LLC
Plano, TX
04.2022 - 04.2024
- Resolved appeals through negotiations with insurance companies, attorneys, and other parties.
- Evaluated medical records to ensure accuracy of diagnoses and treatments.
- Collaborated with physicians, nurses, administrators, and other staff members to resolve issues quickly and efficiently.
- Reviewed denied claims for potential resubmission or reconsideration.
- Answered incoming calls from providers seeking assistance with appeals processing.
- Tracked progress of ongoing appeals cases using computer software systems.
- Prepared reports summarizing trends in appeal outcomes and identified areas for improvement.
- Maintained records of all appeal activities in a timely manner.
Outpatient Medical Biller
Post Acute Medical LLC
Plano, TX
05.2021 - 12.2021
- Facilitated accounts receivables for LTAC and IRF, boosting cash flow and reducing payment delays.
- Generated reports in order to track payments due from insurance companies or other third party payers.
- Compiled and processed data for billing purposes utilizing billing software programs.
- Researched discrepancies between billed charges and payments received from insurance companies or other third-party payers for resolution.
- Verified medical codes for diagnosis, treatments, procedures and supplies using ICD-10 coding system.
- Performed follow-up activities on unpaid claims with insurance companies or other third-party payers by phone or written correspondence within the standard time frame.
- Aggressively tackled aged accounts (120+ days), expediting cash flow and minimizing bad debt to improve overall financial health.
Unemployed
Euless, TX
12.2020 - 05.2021
- Focused on personal growth and skill enhancement during pandemic-related employment gap.
- Utilized time for self-improvement and mental well-being amid the global health crisis.
- Engaged in self-directed learning to stay current with industry trends during downtime.
Medical Billing & Payment Posting Specialist
Fundamental Administrative Services LLC
North Richland Hills, TX
05.2019 - 11.2020
- Fostered strong relationships with skilled nursing facilities, providing comprehensive A/R reviews and strategic guidance to improve financial performance.
- Reconciled accounts and analyzed trends, enhancing month-end closing efficiency.
- Generated daily, weekly, and monthly reports, as well as cash spreadsheets, for reporting and submission.
- Reviewed and processed credit card transactions from payers and patients.
- Optimized payer claim submissions by implementing rigorous coding checks, ensuring timely payments, and minimizing claim rejections.
- Streamlined A/R processes, enhancing cash flow and reducing bad debt write-offs through meticulous account monitoring and proactive collection strategies.
- Mentored new team members on company policies and A/R best practices, facilitating their seamless integration and boosting overall team efficiency.
Billing Account Representative
Vibra Healthcare
Irving, TX
07.2018 - 05.2019
- Streamlined billing processes for Long Term Acute Care and Inpatient Rehab facilities, enhancing claim processing efficiency by minimizing claim denials and optimizing revenue recovery.
- Maintained zero balances on all accounts receivable over 30 days, ensuring compliance with billing timeframes and guidelines for assigned facilities.
- Developed targeted solutions for unpaid accounts by identifying trends, leading to improved revenue recovery and successful audit reviews.
- Fostered strong relationships with insurance contacts, expediting claim dispute resolutions and enhancing interdepartmental communication for timely coding updates.
- Investigated discrepancies in customer account balances and resolved issues promptly.
- Monitored changes in industry regulations related to billing practices and ensured compliance with laws and regulations.
- Generated detailed reports on daily, weekly, and monthly basis for management review.
Denials Specialist & Appeal Writer
Conifer Health Solutions
Frisco, TX
04.2016 - 06.2017
- Resolved claim denials by identifying root causes, improving resolution rates.
- Facilitated the appeals process by meticulously reviewing claim denials, identifying errors, and presenting compelling arguments, leading to successful outcomes.
- Partnered with the Clinical Resource Center for consultations and referrals, ensuring comprehensive claim resolution and optimal patient care coordination.
- Successfully initiated the new interdepartmental Medicare unit, providing payer-specific collections and claims processing for a major client with 90% claim submission accuracy.
- Maintained meticulous records and upheld strict compliance standards, contributing to successful audit reviews and improved financial performance.
Education
Certified Professional Coder (CPC) -
American Academy of Professional Coders
Euless, TX08.2024
Human Resource Management -
University of Phoenix
Philadelphia, PA01.2007
Diploma - Business Management
Germantown High School
Philadelphia, PA01.1993
Skills
- Revenue Cycle Management
- Insurance Billing Expertise
- Billing Software
- Detail-Oriented Mindset
- Analytical Problem Solving
- Effective Team Collaboration
- Effective Communication
- Responsive to New Challenges
- Billing Accuracy
- Microsoft Office Proficiency
- Strategic Organization
Accomplishments
- Resolved three month VA payment issue resulting in high dollar payment of $30,890.00 on an account - 2018
- First contractor to appear in Healthcare Support company's first newsletter as an All-Star Candidate - 2016
- Exceeded department KPI goals with 108% efficiency, 92% utilization and 100% productivity for one whole year - 2015
- Set up company's new interdepartmental Medicare units in 2004 & 2010
- Supervised a team in 2004 & 2010
- Earned Independence Blue Cross Blue Diamond Award for Excellence in Performance - 2006
- Earned "Employee of the Year" in 2004
- Created & facilitated company's first Time Management Training Program for managerial and non-managerial employees in 2004
- Earned company's first LFC award (Listens, Follow-Up and Cares) as standard of excellence in customer service in 2004
Certification
- Certification of Achievement - Aetna Training Program - 2003
- Providers Services Degree - Independence Blue Cross - 2004
- Certification of Completion - Colonial Penn Sales Training Program - 2010
Timeline
Sabbatical-
Pursued Additional Education
04.2022 - 07.2024
Clinical Appeals Coordinator
Post Acute Medical LLC
04.2022 - 04.2024
Outpatient Medical Biller
Post Acute Medical LLC
05.2021 - 12.2021
Unemployed
12.2020 - 05.2021
Medical Billing & Payment Posting Specialist
Fundamental Administrative Services LLC
05.2019 - 11.2020
Billing Account Representative
Vibra Healthcare
07.2018 - 05.2019
Denials Specialist & Appeal Writer
Conifer Health Solutions
04.2016 - 06.2017
Certified Professional Coder (CPC) -
American Academy of Professional Coders
Human Resource Management -
University of Phoenix
Diploma - Business Management
Germantown High School
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