Kelsey Autin
Montegut,LA
Summary
Resourceful and detail-driven Prebilling Specialist with extensive hands-on experience in lab claim preparation, payer compliance, and insurance eligibility across commercial and government payers. Known for catching issues before they become problems, streamlining complex processes, and building tools that make work easier for the entire team. Creator of SOPs, training resources, and reference guides used daily across departments. I’m the kind of person who thrives on solving problems and making things run smoother—whether it’s cleaning up a complicated claim, or building tools that help the whole team stay on the same page.
Overview
5
5
years of professional experience
Work History
Pre Billing Specialist
Physicians Group Laboratories
Houma, LA
08.2023 - Current
- Manage and clean laboratory claims prior to billing, carefully aligning each with payer-specific guidelines to ensure accuracy, compliance, and reduced denial rates.
- Work with both government and commercial insurance payers across all lab panels, including Respiratory, GI, STI, UTI, BV, and Wellness, adjusting claims to reflect panel-specific coding rules.
- Review diagnosis coding sequences for medical necessity, remove non-compliant or unsupported codes, and confirm eligibility status before submission.
- Collaborate with internal teams—including compliance, analysts, accessioning, and revenue cycle leadership—to resolve claim discrepancies and prevent processing delays.
- Authored a full prebilling SOP from scratch during a major panel rollout; created detailed, visual guides outlining billing rules by panel and payer to improve team clarity and reduce errors.
- Trained multiple team members across departments, and participated in cross-training programs to build confidence, consistency, and understanding of complex billing workflows.
- Provide feedback for continuous process improvement, contributing to SOP updates, system enhancements, and clearer communication between departments.
- Developed the Default Panel Spreadsheet, a centralized reference tool used to verify proper code assignments by panel, improving consistency, and reducing manual errors.
Medical Records Specialist
Physicians Group Laboratories
Houma, LA
07.2022 - 08.2023
- Managed insurance payer record requests and audit documentation with strict adherence to HIPAA compliance.
- Pulled and compiled records for both internal and external audits, working cross-departmentally to ensure accuracy and timely submission.
- Completed regular documentation audits and improved internal processes for record organization and accessibility.
Secretary
Gulf South Homes
Houma, LA
01.2022 - 05.2022
- Served as the first point of contact for clients and visitors, delivering professional, friendly service to the general public, both in person and over the phone.
- Handled secretarial tasks included document filing, invoice organization, and maintaining confidential records with accuracy and discretion.
- Created and maintained new customer packets, ensuring all records were complete and up to date.
- Accurately input employee hours for payroll processing, demonstrating trustworthiness and attention to detail.
- Efficiently managed high volume, multiline phone systems while juggling administrative duties without missing deadlines.
Boutique Owner
Toonie Rae' Boutique
Chauvin, LA
07.2020 - 05.2022
- Launched and managed an online boutique, overseeing all aspects of business operations, including inventory management, order fulfillment, and customer service.
- Handled financial responsibilities such as budgeting, pricing, invoicing, and sales tracking.
- Created and executed marketing strategies across social media to grow brand presence, and drive sales.
- Designed product listings, coordinated with vendors, and ensured smooth day-to-day operations.
Education
High School Diploma -
South Terrebonne High School
Bourg, LA05-2011
Skills
- Payer guidelines
- Team collaboration
- Time management
- Effective communication
- Claim submission
- Attention to detail
- Employee training
- Customer service
- Process improvement
- HIPAA compliance
- Problem solving
- Insurance claim processing
- Billing systems and software
- Insurance confirmation
- Procedure development
- Records organization and review
- Analytical thinking
- Multitasking and organization
- Insurance verification
- Data entry proficiency
Timeline
Pre Billing Specialist
Physicians Group Laboratories
08.2023 - Current
Medical Records Specialist
Physicians Group Laboratories
07.2022 - 08.2023
Secretary
Gulf South Homes
01.2022 - 05.2022
Boutique Owner
Toonie Rae' Boutique
07.2020 - 05.2022
High School Diploma -
South Terrebonne High School
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