Janita Lyles
Arlington,TX
Summary
Dedicated and hardworking job seeker with 15 years of experience in revenue cycle management including Epic Hyperspace, Cerner, Microsoft office and Excel. Expertise in effective leadership, task assignment, process improvements,employee training, constructive feedback, conflict mediation, analytical thinking & problem solving. Confident in motivating team success and contributing to company growth and success. HIPPA & JACHO compliant
Overview
19
19
years of professional experience
Work History
OR Coordinator II
Baylor Scott & White
06.2022 - Current
- Coordinate Orthopedic surgical procedures: including scheduling, prior authorizations, verify surgical benefits, provide cost estimates and medical clearances
- Work as liaison between physician, facilities, anesthesia, and patients to ensure patient safety.
- Educated patients about surgeries and provided treatment plan documentation.
Billing Representative I
UT Southwestern Medical Center
11.2021 - 06.2022
- Input physicians charges into Epic Hyperspace to acquire revenue
- Monitored outstanding invoices and performed collections duties.
- Audited and corrected billing and posting documents for accuracy.
- Generated monthly billing and posting reports for management review.
- Reviewed and solved account and billing discrepancies.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Worked effectively with medical payers such as Medicare, Medicaid, and commercial insurances to obtain timely and accurate payments.
Clinical Reviewer
US Oncology
11.2020 - 11.2021
- Provided Chemotherapy and Radiation prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
- Accurately document approvals into the IKnowMed EMR according to organization's requirements to generate revenue
- Facilitated coverage uninsured pts for planned treatments & procedures.
Prior Authorization Specialist
Regions Hospital
08.2019 - 09.2020
- Acquire compassionate usage medications from pharmaceutical manufacturers for underinsured patients.
- Record, track and order compassionate usage medications per physicians' orders, ensure patient safety
- Prior authorizations for Chemotherapy treatments.
- Facilitated communication between the pharmacy team and medical providers for seamless prescription processing and patient care coordination.
Patient Financial Counselor
US Oncology
06.2017 - 08.2019
- Interviewed patients to determine coverage and financial assistance through grants and foundations
- Screen and assist with Medicaid enrollment
- Establish and collect payment arrangements
- Obtain prior authorizations for Chemotherapy treatments and Radiation services.
Charge Entry and Financial Screener
Gillette Specialty Healthcare
02.2014 - 06.2017
- Accurate entry of medical and dental charges, prepare batch totals using tenkey for balancing
- Provide cost estimates and screen patients for financial counseling services.
Ambulatory Health Unit Coordinator-Lead
Children's Hospital and Clinics of MN
06.2007 - 11.2012
- Managed front desk staff, schedule appointments, check in/out patients
- Coached, and developed front office associates.
- Worked closely with Triage team to assist with walk-in, nurse visits, school /medical forms, medication refills request
- Transcribe Med/Surg physician orders, order, and stock unit supplies, greet patients and families to unit.
Emergency Room Clerk and Health Unit Coordinator
Regions Hospital-Emergency Room
04.2005 - 03.2007
- HUC-Transcribe Coronary care unit physician orders, order and stock unit supplies as needed, general clerical duties, greet patients and families to unit
- Clerk- Check in patients and perform in room registrations including interviewing patients to collect demographics and insurance information in a timely manner.
Education
Certification - Health Unit Coordination
Saint Paul College - A Community And Technical College
Saint Paul, MN08.2003
Skills
- Claims (1500) Processing Proficiency
- Patient Registration & Insurance verification
- Denial Management
- Financial Counseling
- Medical Billing & Collections
Timeline
OR Coordinator II
Baylor Scott & White
06.2022 - Current
Billing Representative I
UT Southwestern Medical Center
11.2021 - 06.2022
Clinical Reviewer
US Oncology
11.2020 - 11.2021
Prior Authorization Specialist
Regions Hospital
08.2019 - 09.2020
Patient Financial Counselor
US Oncology
06.2017 - 08.2019
Charge Entry and Financial Screener
Gillette Specialty Healthcare
02.2014 - 06.2017
Ambulatory Health Unit Coordinator-Lead
Children's Hospital and Clinics of MN
06.2007 - 11.2012
Emergency Room Clerk and Health Unit Coordinator
Regions Hospital-Emergency Room
04.2005 - 03.2007
Certification - Health Unit Coordination
Saint Paul College - A Community And Technical College