Kori Lawson
Butte,MT
Summary
Detail-oriented Medical Records Director/Authorization Specialist with a proven track record in managing and processing insurance claims while ensuring document accuracy. Expertise in analytical problem-solving and effective time management has led to significant improvements in claim processing efficiency and accurate payouts. Aiming to leverage skills in a dynamic team environment to enhance operational workflows.
Overview
15
15
years of professional experience
Work History
Medical Records Coordinator/Authorization Specialist
Continental Care & Rehabilitation
Butte, MT
06.2023 - Current
- Coordinated operational activities concerning medical records and the pulmonary program while overseeing Points of Corrections for State Survey.
- Monitored and assessed resident medical files regularly for adherence to health care regulations.
- Facilitated understanding of medical records while ensuring HIPAA compliance.
- Reviewed and verified insurance claim authorization submissions.
- Fill in for the Admissions Coordinator and the Business Office Manager when required
- Provided nutrition education to patients, families, and staff members.
- Adhered to all local, state, federal regulations pertaining to dietary management practices.
- Collaborated with team members to deliver exceptional customer service.
- Created processes and systems for ensuring ongoing compliance with relevant rules and regulations.
- Responded promptly to inquiries from government agencies regarding regulatory issues.
- Collaborated with external parties such as auditors, lawyers, regulators.
- Conducted research, when needed, into various types of policies, procedures, and regulations related to different types of claims.
- Performed data entry into internal systems to process claims requests.
- Developed relationships with external stakeholders such as medical providers and employers, in order to obtain necessary information for successful claims resolution.
- Collaborated with team members to develop strategies for resolving difficult cases quickly and efficiently.
- Answered inquiries from customers regarding their individual claims status.
- Performed quality control checks on completed files prior to final submission for payment authorization purposes.
- Generated correspondence to customers regarding claim decisions or other pertinent information.
- Maintained accurate records related to all aspects of the claims process.
- Managed incoming mail consisting of new applications and and or additional documentation required for existing open claims files.
- Assisted in the preparation of documents for claims processing.
- Provided customer service support to policyholders, claimants, and agents over the phone or via email.
- Ensured compliance with HIPAA regulations when dealing with confidential patient information.
- Assisted in developing strategies for improving overall compliance performance.
- Reviewed and updated existing compliance policies and procedures.
- Conducted periodic internal audits to ensure compliance with applicable regulations.
- Participated in meetings between senior leadership teams to discuss any potential violations or concerns about regulatory issues.
- Drafted reports outlining findings from compliance audits and investigations.
- Identified key issues regarding workflow processes by assisting professionals with quality reviews.
- Coordinated with various departments within the organization to ensure adherence to established standards.
- Reviewed and verified insurance claim forms to ensure accuracy and completeness of information provided by claimants.
Small Business Owner
Goose-n-Bear
Wisdom, MT
11.2018 - 12.2023
- Supervised day-to-day activities in coffee shop, bakery, and retail environments.
- Oversaw sales performance and daily operations, identifying potential growth areas.
- Enhanced brand awareness throughout the region using targeted social media promotions.
- Enhanced visibility through strategic product placement aligned with seasonal trends.
- Managed shrinkage to control profit and loss.
- Supervised processes for inventory intake.
- Conducted thorough performance evaluations to assess staff effectiveness.
- Refined transaction workflows, boosting customer satisfaction.
- Identified and pursued opportunities for expansion into untapped markets.
- Performed in-depth analysis of competitors to identify unique market advantages.
- Monitored organizational performance data to uncover improvement opportunities.
- Secured funding for operational costs tied to retail space, workforce expansion, and equipment acquisition.
- Introduced diverse menu offerings influenced by customer feedback.
- Executed vendor supply orders efficiently, keeping within the established budget.
- Coordinated staff training in customer service, food handling, and safety standards.
- Managed and resolved client concerns to uphold strong customer relationships.
- Conducted routine maintenance assessments to verify equipment functionality.
- Demonstrated outstanding customer service by proactively addressing customer needs.
- Maintained regulatory guidelines for food preparation set by the health department.
- Directed daily management tasks such as schedule planning, budget administration, and inventory oversight.
- Photographed products for sale and posted pictures online to increase visibility and showcase current product availability.
- Participated in local community activities to promote the brand's visibility and reputation.
Adult Foster Care and Administration Coordinator
Center for Mental Health
Helena, MT
09.2016 - 11.2018
- Ensured client needs were met by selecting, developing, and retaining qualified staff.
- Developed effective strategies to coordinate timely home visits with adult foster care providers.
- Ensured adherence to federal, state, and local regulations.
- Created and delivered training curriculum for adult foster care providers to senior staff.
- Built trust by accurately understanding problems of clients and care providers.
- Became familiar with community resources.
- Identified potential risks through detailed risk evaluations.
- Oversaw adherence of departmental processes to relevant laws and regulations.
- Spearheaded employee education efforts to ensure compliance with evolving rules and operational protocols.
- Responded promptly to inquiries from government agencies regarding regulatory issues.
- Liaised with third parties like auditors, lawyers, regulators.
- Generated monthly progress reports on organizational goals.
- Attended community events that promoted awareness about available resources for at-risk populations.
- Assisted in recruiting, training, certifying, and evaluating new foster care providers.
- Responded to online or telephone requests for information and assistance.
- Maintained confidentiality through stringent handling of charts and data.
- Worked with care team to assess client needs and discuss collaborative treatment efforts.
- Researched potential placements for new referrals into the program.
- Provided case management services, including monitoring, advocacy, and support.
- Provided crisis intervention services when needed.
Aeromedical Assistant & Medical Records
Montana National Guard & Army Reserves
03.2010 - 03.2018
- Rank: SGT.
- MOS: 31B and 42A.
- Honorable Discharge.
- DoD Aeromedical Physician Assistant (APA)
- Led squad during annual and tabletop training exercises.
- Performed detailed assessments collaboratively with flight surgeon to verify aircrew fitness.
- Monitored Soldiers' medical status to maintain readiness.
- Handled a variety of administrative operations supporting healthcare services.
- Established operational systems for continuous regulatory compliance.
- Responded promptly to inquiries from government agencies regarding regulatory issues.
- Responded promptly to inquiries from governmental agencies regarding compliance matters.
- Maintained accurate records of all activities related to compliance monitoring.
- Prepared monthly reports on progress made towards meeting organizational goals around compliance matters.
- Ensured compliance with HIPAA regulations for secure patient data handling.
- Implemented regulations and laws within the military.
- Enhanced expertise with ongoing education and specialized training.
- Demonstrated strong problem-solving skills, resolving issues efficiently and effectively.
- Worked with cross-functional teams to achieve goals.
- Provided support and guidance to colleagues to maintain a collaborative work environment.
- Managed time effectively to ensure tasks were completed on schedule and deadlines were met.
- Utilized advanced technical skills and expertise to troubleshoot complex problems and implement solutions.
Education
Associate's - Human Services in Child and Family Services
Purdue University Global
Lafayette, IndianaGraduate -
Beaverhead County High School
Dillon, MontanaSkills
- Strategic Marketing Planning
- Project Coordination
- Analytical Problem-Solving Skills
- Commitment to Ethical Practices
- Health Records Management
- Information Storage Management
- Communication
- Cost Control Analysis
- Effective Team Collaboration
- Computer Proficiency
- Proficient in Organization
- Forward-Thinking Solutions
- HIPAA Compliance Expertise
- Audit Report Preparation
- Efficient Data Management
- Analytical Investigation Methods
- Auditing processes
- Compliance Audit Facilitation
- Comprehensive Reporting Ability
- Proficient Research Skills
- Comprehensive Review Skills
- Dynamic Time Management
- Coverage determination
Timeline
Medical Records Coordinator/Authorization Specialist
Continental Care & Rehabilitation
06.2023 - Current
Small Business Owner
Goose-n-Bear
11.2018 - 12.2023
Adult Foster Care and Administration Coordinator
Center for Mental Health
09.2016 - 11.2018
Aeromedical Assistant & Medical Records
Montana National Guard & Army Reserves
03.2010 - 03.2018
Associate's - Human Services in Child and Family Services
Purdue University Global
Graduate -
Beaverhead County High School
References
Available upon request.
Work Preference
Work Type
Full TimeWork Location
RemoteImportant To Me
Work-life balanceCompany CultureWork from home optionAccomplishments
- Honorary Discharge
- 2 Army Commendation Medals
- Excellence Achievement from the Montana National Guard 1-189th General Support Aviation Battalion (GSAB).
- Supervised team of 5 staff members.
- Collaborated with team a of 4 in the development of the Team Excellence Committee.
- Used Microsoft Excel to develop inventory tracking spreadsheets.
- Achieved 90% by completing Triple-Check with accuracy and efficiency.
Quote
Be more concerned with your character than your reputation, because your character is what you really are, while your reputation is merely what others think you are.
John R. Wooden
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
swipe to browse
Similar Profiles
Abiola AwonusiAbiola Awonusi
CNA at Continental Nursing @ Rehabilitation CenterCNA at Continental Nursing @ Rehabilitation Center
Keaton YuloKeaton Yulo
Dietary Aide at Continental Nursing & Rehabilitation CenterDietary Aide at Continental Nursing & Rehabilitation Center
Maxi GuioMaxi Guio
CNA Preceptor at Continental Nursing & Rehabilitation CenterCNA Preceptor at Continental Nursing & Rehabilitation Center
Sidney MeeksSidney Meeks
Unliscend Assistive Personal at Frances Mahon Deaconess HospitalUnliscend Assistive Personal at Frances Mahon Deaconess Hospital
Christopher SalmonsenChristopher Salmonsen
Fuel Material Handler at Big Bear RepairFuel Material Handler at Big Bear Repair