Jennifer Lah
Parma
Summary
Experienced with client relationship management, enhancing customer satisfaction through personalized service and strategic account planning. Utilizes negotiation and conflict resolution skills to maintain and renew client contracts, ensuring alignment with business objectives. Track record of leveraging analytical insights to drive client retention and business development.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Provider Relationship Account Manager-Medicaid, Commercial, Medicare
Anthem
08.2022 - Current
- Building and maintaining relationships with the providers
- Working and troubleshooting claim issues, filing Interact tickets as needed for claim resolution
- Conducting monthly JOC meetings and resolving any issues
- Running reports in Thoughtspot and reviewing with providers
- Working with contracting department in having contracts loaded in/reviewing contracts with claims
- Logging into ODM’s PNM and running reports against Provider Set Up Reports
- Working with management staff with any issues that need escalated
- System Experience in WGS, CMS, Facets, Macess, SPS, Ohio Department of Medicaid and PNM, DocHub, Interact, Contraxx, Member 360, NEXTGEN, Salesforce, Perm, Excel
Bill Review Specialist
888-Ohio Comp
01.2014 - 01.2024
- Data entry of worker's comp claims that come in from providers on HCFA or UB
- Keeping up with accuracy and speed while working all claims
- Reviewing medical claims for authorizations, medical documentation
- Answering phones from providers and injured workers regarding payments or denials
Account Administrator-Sales
Medical Mutual
01.2020 - 01.2022
- Setting up new accounts from prescreens received from the brokers for small groups
- Sending information to underwriting for quoting process
- Assisting sales rep and forwarded quote to broker
- Starting enrollment process with scrubbing and checking for errors
- Following up with brokers with any issues or changes
- Working the different region queues in the system
- Assigned main queue and dividing into different regions twice a month
Benefit Services Assistant
Medical Mutual
01.2017 - 01.2020
- Working mailboxes and dividing work between BI’s and coding
- Compiling daily reports on Excel
- File check and review account worksheets with CMS/Hummingbird
- Update comment codes from requests
- Removing and/or putting group MMI’s on hold in CMS and Onbase
- Work on projects for coding, and Benefit Implementation in making changes to WEBBEN
- Entering all provider information to update directory
- Loading contract products into system with knowledge of all contracts
- Ending inactive provider locations
- Working daily quotas in a timely matter
- Interacting with contracting department with any issues or discrepancies
- Keying in claims for unidentified providers
Insurance agent- Part time
United Healthcare AARP
01.2015 - 01.2017
- Contacting all prospect leads in queue
- Scheduling appointments with potential clients
- Presenting and selling products that fits the clients needs
- Following up with client with all questions and concerns
Medical Biller
Balance Solutions
01.2012 - 01.2014
- Data entry of all medical bills
- Insurance follow up on any aging accounts from insurance carriers
- Posting payments, adjustments and processing any payment recoveries
- Handling all bank deposits
- Answering phones, scheduling appointments, checking patients in
Insurance Agent
Banker's Life and Casualty
01.2011 - 01.2012
- Cold calling on all potential leads
- Scheduling appointments, and going out on appointments
- Presenting all products to the potential client, selling products to the clients
- Keeping rapport with the clients for possible potential of selling other products
Education
Certificate - Life and Health Insurance
Hondros College
Independence, OH01.2011
Certificate - Medical Office and Medical Billing
Auburn Career Center
Concord, OH01.1999
Skills
- An Ohio licensed Health and Life insurance agent since 2011
- I have sold health, life insurance, dental, critical illness, disability, long term care products
- A strong and experienced Insurance/Medicare/Medicaid and commercial billing background
- Experienced medical biller for over 10 years with all carriers including Medicare/Medicaid
- Several years experience in customer service and management in retail and medical field
- Have processed claims in medical billing process, posted payments, posted adjustments
- Knowledge of hospital and professional contracts
- Putting together data reports and reviewing any issues
- Account management
- Teamwork and collaboration
- Client relations
- Customer service
- Client relationship management
- Relationship building
Certification
Ohio Life and Health, 01/01/11, Present
Additional Professional Experience
- Insurance Agent
- Contract Experience
- Medical Billing
- Medical Billing Manager
- Business Office Manager
- Provider Services Manager
- Also have 13 years in retail management and customer service.
Timeline
Provider Relationship Account Manager-Medicaid, Commercial, Medicare
Anthem
08.2022 - Current
Account Administrator-Sales
Medical Mutual
01.2020 - 01.2022
Benefit Services Assistant
Medical Mutual
01.2017 - 01.2020
Insurance agent- Part time
United Healthcare AARP
01.2015 - 01.2017
Bill Review Specialist
888-Ohio Comp
01.2014 - 01.2024
Medical Biller
Balance Solutions
01.2012 - 01.2014
Insurance Agent
Banker's Life and Casualty
01.2011 - 01.2012
Certificate - Medical Office and Medical Billing
Auburn Career Center
Certificate - Life and Health Insurance
Hondros College
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