Lakeshia Byrd
Louisville,KY
Summary
Credentialing Specialist with over 10 years of experience in several areas of Health Information Management. Strong background in optimizing provider credentialing processes. Proven record in ensuring compliance with industry standards, conducting thorough credential verifications, and maintaining accurate databases. Seeking to contribute experience and drive efficiency in a dynamic healthcare environment.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Contract and Credentialing Specialist
BrightSpring Health Services
Louisville , KY
2022.10 - Current
- Oversee the comprehensive credentialing process for healthcare providers, ensuring alignment with industry standards and organizational requirements.
- Assisted in the credentialing and recredentialing of healthcare providers, managing the entire process from application to approval.
- Developed and maintained positive relationships with providers, addressing concerns and providing support throughout the credentialing process.
- Maintained and updated CAQH accounts for all providers quarterly.
Medicare Supplement Enrollment & Billing Specialist
Anthem, Inc (Contracted)
Louisville , KY
2021.09 - 2022.01
- Responsible for enrollment, billing activities, and maintaining assigned accounts
- Maintains and reconciles premium bill, self-bill and individual billed accounts.
- Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
- Determines eligibility and applies contract language for each case assigned.
Outpatient/Inpatient Coder
HIM, University of Louisville Hospital
Louisville , KY
2018.04 - 2020.12
- Assigned appropriately ICD-10-CM/CPT codes for oncology, radiation oncology, ancillary, and rehab outpatient services.
- Assigned appropriately ICD-10-CM/PCS codes for inpatient accounts.
- Utilized technical coding principles and MS-DRG reimbursement expertise to assign codes.
- Reconciled NCCI, LCD, and Pre Bill edits and discrepancies prior to final billing.
- Met and exceeded coding productivity requirements while maintain quality performance in accordance with company policies.
- Assigned modifiers and sequenced codes appropriately to accurate reflect services provided.
Education
Bachelor's - Exercise Science
University of Louisville
Skills
- License Verifications
- Pecos/NPPES
- Credentialing Software
- Contract Negotiation
- NCQA Standards
- Effective communication skills
- ICD 10/ CPT Coding
- Claims/ Appeals
- Benefit Verification
- Prior Authorizations
- Time Management
- Attention to detail
- Medical Terminology
- Cerner/ Epic Systems
- HIPAA Compliance
Certification
Certified Coding Associate October 2017 to Present
AHIMA credential
Timeline
Contract and Credentialing Specialist
BrightSpring Health Services
2022.10 - Current
Medicare Supplement Enrollment & Billing Specialist
Anthem, Inc (Contracted)
2021.09 - 2022.01
Outpatient/Inpatient Coder
HIM, University of Louisville Hospital
2018.04 - 2020.12
Bachelor's - Exercise Science
University of Louisville
Certified Coding Associate October 2017 to Present
AHIMA credential
Similar Profiles
Terrell TaylorTerrell Taylor
Human Resources Specialist at Brightspring Health ServicesHuman Resources Specialist at Brightspring Health Services
Aziza HenryAziza Henry
Revenue Cycle Implementation Specialist at BrightSpring Health ServicesRevenue Cycle Implementation Specialist at BrightSpring Health Services
Erica StewartErica Stewart
Home Health CNA/Direct Support Professional at BrightSpring Health ServicesHome Health CNA/Direct Support Professional at BrightSpring Health Services