Jennifer Leisure
Grand Blanc,MI
Summary
Strategic and results-driven healthcare professional with over 10 years of experience in medical billing, appeals, revenue cycle operations, and patient financial advocacy. Proven success in leading appeals and grievance functions, resolving high-dollar claim disputes, and optimizing AR recovery processes. Skilled in cross-functional collaboration, staff resource planning, payer compliance, and financial assistance programs. Strong knowledge of CMS, Medicaid, and commercial payer requirements. Passionate about improving healthcare affordability, payment accuracy, and patient satisfaction.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Grievance and Appeals Coordinator
Blue Cross Blue Shield of Michigan
01.2023 - Current
- - Lead resolution of member and provider appeals related to medical necessity, billing errors, and coverage denials.
- - Collaborate with legal, clinical, and operational departments to support claim adjudication and AR recovery.
- - Assist patients in understanding benefit structures and resolving complex billing issues with providers and payers.
- - Monitor KPIs related to case volume, resolution time, and audit readiness.
- - Educate patients on financial resources such as payment plans, Medicaid waivers, and charitable aid programs.
Grievance and Appeals Coordinator
McLaren Health Plan
04.2018 - 01.2023
- - Managed high-volume appeal and grievance caseloads, ensuring compliance with CMS and NCQA requirements.
- - Communicated complex billing and denial scenarios to patients in a clear and supportive manner.
- - Identified denial trends, developed reports, and recommended process improvements to reduce write-offs and enhance recoveries.
- - Supported leadership with resource planning and case assignment adjustments based on forecasted volume.
Customer Service Representative
McLaren Health Care
03.2016 - 04.2018
- - Responded to inquiries regarding insurance eligibility, claims, and out-of-pocket costs.
- - Delivered front-line patient financial education and resolved payment disputes.
Front Office & Billing Coordinator
Beecher Surgical Associates
01.2014 - 01.2016
- - Managed front desk operations including scheduling, patient registration, and insurance verification.
- - Secured authorizations for surgical procedures and ensured eligibility compliance.
- - Handled full-cycle billing, coding (CPT, ICD-10, HCPCS), and AR follow-up for a multi-provider practice.
- - Resolved claim denials, submitted appeals, and communicated directly with insurance payers.
- - Maintained HIPAA compliance while improving operational efficiency and patient service.
Teacher’s Aide & 1:1 Support Staff
Michigan School for the Deaf
01.2007 - 01.2012
- - Provided classroom support to students with hearing impairments and special needs.
- - Served as a dedicated one-on-one aide to a student with physical and cognitive disabilities.
- - Assisted in the development of learning strategies tailored to ASL and individual needs.
- - Fostered communication between students and staff using American Sign Language.
Education
Elementary Education
Baker College of Owosso
Skills
- Revenue Cycle & Insurance Recovery
- Appeals & Grievance Management
- Third-Party Billing (Medicare, Medicaid, Commercial)
- Denials Management & Claims Resolution
- Patient Advocacy & Financial Education
- Resource Planning & KPI Monitoring
- Regulatory Compliance (CMS, HIPAA, ACA)
- Cross-Functional Collaboration
- ASL Fluent Microsoft Office EMR & Case Management Systems
Certification
- - SLPI-10: Sign Language Proficiency Interview – Advanced level (ASL)
- - On-the-job training in Medical Billing & Coding – McLaren Health Plan
- - HIPAA, CMS, and Medicaid Compliance Training
- - Extensive experience in Revenue Cycle, Appeals, and Insurance Recovery
Languages
- English (Fluent)
- American Sign Language (Fluent)
Timeline
Grievance and Appeals Coordinator
Blue Cross Blue Shield of Michigan
01.2023 - Current
Grievance and Appeals Coordinator
McLaren Health Plan
04.2018 - 01.2023
Customer Service Representative
McLaren Health Care
03.2016 - 04.2018
Front Office & Billing Coordinator
Beecher Surgical Associates
01.2014 - 01.2016
Teacher’s Aide & 1:1 Support Staff
Michigan School for the Deaf
01.2007 - 01.2012
Elementary Education
Baker College of Owosso