Summary
Overview
Work History
Education
Skills
Timeline
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Katherine Clarke

Saint Helens,OR

Summary

Logical Medical Biller proudly offers over 25 years of experience reviewing accounts and maintaining patient records. Focused employee with background in medical terminology, coding, HCFA claim billing, denial management, and full revenue cycle understanding. Organized and helpful team player are my strengths. Recognized task prioritization expertise in fast-paced environments.

Overview

35
35
years of professional experience

Work History

Medical Translator

LabCorp of American
Burlington, NC
01.2024 - Current
  • Reviewed patient medical records for accuracy, completeness and compliance with coding regulations.
  • Coded diagnoses and procedures from patient medical records using ICD-10-CM.
  • Analyzed data from various sources including electronic health records databases, insurance websites, in order to identify potential errors in the coded data sets.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Maintained high accuracy rate on daily production of completed reviews.
  • Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
  • Communicated with healthcare personnel, including practitioners to promote accuracy.
  • Verified proper coding, sequencing of diagnoses and accuracy of [Type] procedures.
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
  • Researched discrepancies between documentation and billing information in order to resolve any issues prior to submission.
  • Maintained up-to-date knowledge of coding changes, updates, and new rules.

Medical Coding Specialist

Legacy Laboratory Services
Portland, OR
05.2013 - 01.2024
  • Researched and resolved coding issues identified by auditors.
  • Maintained up-to-date knowledge of medical terminology and coding changes.
  • Compiled reports on coding accuracy, completeness, and compliance with regulations.
  • Verified accuracy of patient data in order to assign correct ICD-10 codes.
  • Managed daily operations within the department while ensuring compliance with HIPAA regulations.
  • Maintained strict confidentiality with adherence to HIPAA guidelines and regulations.
  • Translated patient information into alphanumeric and numeric medical codes
  • Investigated rejected and denied claims, correcting applicable coding.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.

Account Follow-up Specialist 2

Legacy Laboratory Services
Portland, OR
01.2001 - 05.2013
  • Commercial Insurance Follow-up. Familiar with EPIC, complex knowledge of Cerner.
  • Submitted appeals for denied claims when appropriate according to the insurance company's criteria.
  • Monitored aging accounts receivable balances ensuring timely resolution of outstanding balances.
  • Verified patient information, including medical history and insurance coverage, to ensure accuracy of coding and billing.
  • Submitted claims electronically to insurance companies in accordance with regulations.
  • Researched denied claims to determine the cause of denial and corrected errors as needed.
  • Analyzed trends in denials in order to recommend process improvements which would reduce the number of denials received.
  • Reviewed physician orders, laboratory results, diagnostic images, clinical statements and other health care provider services for completeness and accuracy.

Biller 2, Refund Specialist, Ins Verification

Legacy Laboratory Services
Portland, OR
07.1989 - 05.2001
  • Previous positions within the Revenue Cycle Management & laboratory include:
  • Refund Specialist (all Payors, commercial, govt, state, patient)
  • Biller 1 & 2 (commercial insurance)
  • Insurance Verification Specialist
  • Customer Service Specialist
  • Specimen Processing Representative

Education

High School Diploma -

Lincoln High School
Portland, OR
06-1986

Skills

  • Insurance Verification
  • Patient Billing
  • HIPAA Compliance
  • Teamwork and Collaboration
  • Commercial and Private Insurance
  • Account Reconciliation
  • Multitasking and Organization
  • Billing and Collection Procedures
  • Claims review
  • ICD-10
  • Problem Solving Skills, Decision Making Skills
  • Multi payor systems knowledge

Timeline

Medical Translator

LabCorp of American
01.2024 - Current

Medical Coding Specialist

Legacy Laboratory Services
05.2013 - 01.2024

Account Follow-up Specialist 2

Legacy Laboratory Services
01.2001 - 05.2013

Biller 2, Refund Specialist, Ins Verification

Legacy Laboratory Services
07.1989 - 05.2001

High School Diploma -

Lincoln High School

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