Years of Medical Billing/Coding experience
Lenner Griffin
Raleigh,NC
Summary
Qualified professional with 19+ years proven track record of stellar medical billing/collections support, building patient-centric rapport, process improvement strategies, with strong communications expertise. Excellent communicator and presenter who assimilate well with individuals at all levels of a corporation. Performance-driven individual with a high aptitude of critical needs projects and upper management initiatives. Strong leadership, problem solving and interpersonal communication skills within all levels of business. Ability to work independently and as part of a multi-functional team, being able to handle high workloads, stressful situations, and tight deadlines. Ability to make commitments, track and communicate progress, and follow through until completion.
Overview
16
16
Work History
Billing Implementation Specialist
Qualifacts
03.2022 - 05.2024
- Responsible for coordinating and completing implementations billing module, working closely with partners to understand their billing needs to configure the software application for successful transmission of medical documentation to appropriate payer adjudication of claims
- Deliver billing module training sessions pre and post go live
- Train new users on configuration, billing workflows, and claim cycle
- Facilitate payer testing with multiple different payer clearinghouses to ensure successful go-live
- Resposnible in troubleshooting configuration setup and 837 EDI claim files to be accepted by partners preferred clearinghouse
- Proficient in reading and interpret EDI file types 837,835,270,277
- Acquired ability to self-manage and prioritize multiple tasks while preforming all tasks in a remote environment
- Confidence in dealing with and serving partners through various communication channels
- Participate in annual HIPAA trainings to maintain compliance
Implementation Specialist II
ABILITY Network
08.2020 - 03.2022
- Define project scope, goals and deliverables, plan, schedule and adhere to project timelines and milestones to ensure that each implementation project is successfully executed.
- Manage customer on-boarding experience from initial in-take call to go-live, including customization, configurations, and detailed training
- Documented customer requirements and configure applications to meet customer business processes and payer requirements
- Provided best practice documentation of all implementation project activities, and workflows
- Utilized Salesforce application to resolve customer requests regarding any configuration questions after go live
- Identify beneficial product opportunities for existing customers and communicate to sales team via Salesforce task ticket
- Participated in functional testing of product releases.
- Troubleshooted complex issues using an analytical approach and elevate issues following defined escalation procedures in a 72 hour timeframe ensuring that all communications to customer and internal departments were completed
- Set and continually manage project expectations with customer and effectively communicate project expectations with customer and external parties
Revenue Cycle Manager
Leaps and Bounds Therapy Services
02.2015 - 05.2020
- Effectively used KPIs reports to improve Revenue Cycle Performance-Decreasing A/R and increasing efficiencies.
- Monitored and guided revenue cycle operations.
- Post and reconcile insurance and patient payments. Researched and resolved potential reimbursement issues and underpayments.
- Provided training to the medical and administrative staff to ensure the understanding and interpretation of insurance reimbursement rules.
- Assign ICD-10 and CPT coding to physician’s documentation and audited documentation for appropriateness
- Implemented new practice management software for submission of electronic claims to clearinghouse
- Implemented newly efficient 835 filing process for submission of Community Mental Health Claims
- Processed newly hired provider credentialing paperwork through CAQH
- Followed up on outstanding insurance and patient aging reports
- Re-submitted or appealed insurance claims as necessary
- Preformed monthly reconciliation of insurance and patient payments, using Quickbooks software
Medical Biller/Patient Account Representative
Vein Clinic PA
01.2014 - 09.2015
- Post and reconciled insurance and patient payments
- Researched and resolve incorrect payments, EOB rejections, and other issues with outstanding accounts
- Insured accuracy of insurance claims
- Verified correct ICD-9 and CPT codes
- Set up new patient accounts
- Assigned ICD-10 coding to physician’s diagnosis and insure correct level of service and various other CPT codes
- Processed Monthly patient statements
- Answered and resolved patient billing inquiries and/or discrepancies.
Reimbursement Specialist
Fairview Health Services
02.2012 - 06.2015
- Coded and abstracted clinical and demographic data for clinic encounters using standardized coding regulations, abstracting rules, and company guidelines
- Identified and resolved clinical documentation and charge capture discrepancies to improve quality of the clinical documentation, and reimbursement levels assigned
- Educated multidisciplinary team members,including physicians, as it pertains to frequently changing mandated rules, regulations and guidelines to ensure a complaint coding practices.
HIPAA Compliance Specialist
Virtual Radiologic Professionals
01.2012 - 01.2013
Invoice Review Technical Expert
State Auto/Return to Work
01.2008 - 01.2012
Education
Healthcare Management -
National American University
01.2011 - Current
Medical Billing/Coding and Medical Office Administration -
Wayne County Community College
Skills
- Revenue Cycle Management
- Business Analysis
- Client training
- Revenue Growth
- Highly proficient in multiple EMR's and Clearinghouses
- Process Improvement
- Productivity Enhancements
- Change Management
- HIPAA Compliance
- Patient Services
- Vendor Relations
- Claims/Billing Adjudication
- Respond to Patient Inquiries
- ICD-10 coding/CPT modifiers
- Training and Development
- Reimbursements/Payment Processing
- Diagnosis Coding
- Account Follow-up
- Medical Claim submissions
- Medical Software Configuration and Implementation
Timeline
Billing Implementation Specialist
Qualifacts
03.2022 - 05.2024
Implementation Specialist II
ABILITY Network
08.2020 - 03.2022
Revenue Cycle Manager
Leaps and Bounds Therapy Services
02.2015 - 05.2020
Medical Biller/Patient Account Representative
Vein Clinic PA
01.2014 - 09.2015
Reimbursement Specialist
Fairview Health Services
02.2012 - 06.2015
HIPAA Compliance Specialist
Virtual Radiologic Professionals
01.2012 - 01.2013
Healthcare Management -
National American University
01.2011 - Current
Invoice Review Technical Expert
State Auto/Return to Work
01.2008 - 01.2012
Medical Billing/Coding and Medical Office Administration -
Wayne County Community College
Microsoft Office Experience
- Excel
- Word
- Powerpoint
- SharePoint
- Teams
- Outlook
- BI
Software Programs Experience
- Epic
- MW Software EMR
- McKesson
- Cerner
- EClinical Works
- Inovalon
- Credible(Qualifacts)
- Naivcure
- AS400 Software Systems
- RIS System
- Salesforce