LAMAR FLINTROY
Fort Worth,USA
Summary
I have extensive knowledge with partial hospitalization programs, intensive outpatient programs, and outpatient programs in relation to performing concurrent reviews for clients. I have over10 years of medical experience within billing, UR, and medical assistance. I offer strong dedication to informed patient care, administrative excellence, and confidentiality. I hold experience with solving problems creatively and using tact and diplomacy to achieve win-win outcomes. Team player, comfortable in competitive, fast-paced environments. Effective in handling direct customer inquiries, implementing customer service policies and executing financial responsibilities.
Organized Medical Biller thoroughly versed in medical coding and HIPAA requirements. Personable professional with several years of hands-on experience claiming refunds, reviewing claims, and maintaining billing reports. Accommodating and helpful team player proficient in job-related billing software.
Highly knowledgeable Lead Medical Biller with significant experience in healthcare billing, coding, and management. Skilled at overseeing medical billing processes, ensuring compliance with regulatory standards, and managing teams for optimal performance. Demonstrated ability to streamline operations and improve workflow efficiency. Brings track record of positive impact on revenue cycle management through effective process enhancement strategies.
Overview
5
5
years of professional experience
1
1
Certification
Work History
Lead Billing Specialist
Post Acute Medical (PAM) Health
Plano, TX
- Current
- Conduct orientation and training for new hires to Billing Department
- Help resolve billing issues that arise in the department
- Provide back up for billing specialists and manager when needed
- Analyze accounts receivable reports to ensure timely collections
- Maintain payer portal access for department staff
- Help with the set-up of new software and maintain software modules, including insurance set-up, DDE access, software access, and updating yearly case mixrates, fee schedules, and Payer rates
- Act as the Billing Department contact for Credit Balance Reports
- Finalize the month-end close process and provide the reporting by the deadline
- Other tasks as needed
Ar Specialists (Contract Position)
NOREMAC REIMBURSEMENT SOLUTIONS, LLC
Jupiter, FL
03.2024 - 04.2024
- Gather and verify invoices for appropriate documentation prior to payment
- Maintain accounts receivable records to ensure aging is up to date, credits and collections are applied, uncollectible amounts are accounted for, and miscellaneous differences are cleared
- Perform daily cash management duties, including the recording of bank deposits, updating and distribution of cash receipts logs, and posting of cash to the accounts receivable sub ledger
- Submitting and resubmitting claims to the payer
- Prepare analytical and ratio analyses relevant to A/R management can gain a better understanding of how collection efforts are progressing
Director of Ur & Billing
SIERRA SAGE RECOVERY SERVICES, LLC
Las Vegas, NV
04.2023 - 03.2024
- Update UR census data with new admissions/discharges and level of care (LOC)
- Pre-certify new admission insurance clients with insurance companies
- Complete concurrent reviews for caseload as assigned
- Ensures accurate and timely documentation of authorizations or denials
- Communicate level of care authorizations to clinical team
- Communicate with the facility team if coverage or limitation issues exist
- Manage and track caseloads, corrections needed, billable status, and outstanding items by daily review of reporting
- Refer to facility care team to obtain specific treatment information required to complete payor reviews
- Maintains compliance with State regulations and accreditation standards
- Negotiating with insurance companies to ensure that claims are paid accurately and in a timely manner
- Determining procedures and policies that best ensure effective utilization
- Monitoring reviews to ensure patients receive care in a timely and cost-effective manner
- Preparing analysis and reports on significant utilization trends and effects on resources
- Consulting with physicians and other professionals to improve utilization of services
- Resubmissions of claims, reconsiderations on claims, audits on claims and insurance payments performing administrative support tasks, such as preparing and sending out invoices to patients
- Making follow up calls to existing patients, submitting referrals for patient services, transcribing audio dictations, preparation of report templates, management of patient care
Medical Assistant
MARILYN STRADA PHD, LLC
Las Vegas, NV
12.2020 - 09.2022
- Placing calls to patients and potential patients on behalf of Dr
- Strada, on an as needed basis, as assigned daily Monday to Friday, following specific script instructions provided for scheduling, patients, services, or other business-related matters
- Placing calls to health insurance companies to verify patient benefits and eligibility, placing calls to health insurance companies to investigate, clarify, and resolve claim status, claim denials, and claim appeals as necessary
- Resubmissions of claims, reconsiderations on claims, audits on claims and insurance payments performing administrative support tasks, such as preparing and sending out invoices to patients
- Making follow up calls to existing patients, submitting referrals for patient services, transcribing audio dictations, preparation of report templates, management of patient care
Medical Office Lead
BOTTOM LINE EXECUTIVES, INC
Las Vegas, NV
12.2019 - 04.2020
- Coordinated patient scheduling, check-in, check-out, and payments for billing
- Adhered to strict HIPAA guidelines to protect patient privacy
- Entered procedure codes and diagnosis codes into medical billing software.Contract Review and Negotiation
- Review and negotiate business agreements, including multi-channel distribution, manufacturing, software and service, IP and licensing
Member Service Representative
C3/ CUSTOMER CONTACT CHANNELS
Las Vegas, NV
06.2019 - 12.2019
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction
- Assisted members with correcting account, service, and system issues by educating on required forms and technical processes
- Professionally handle a high volume of incoming calls thoroughly and efficiently gather customer information, assess, and fulfill customer needs and educate customers where applicable regarding products and services listed above
- Ability to utilize and navigate multiple systems simultaneously, be dependable and meet all attendance requirements, resolve customer issues via one call resolution guidelines and/or escalated process, meet or exceed company and client performance metrics, maintain a balance between company policy and client benefit in decision making
- Continuously evaluate and identify opportunities to drive process improvements that positively impact our client and its customers
- Responsible for call disposition or compiling and generating reports as required Ability to accept and embrace changes within the current business environment Third party for Humana Coding/Medical Billing
Education
BACHELOR'S DEGREE - CRIMINAL JUSTICE
UNIVERSITY OF LAS VEGAS
Las Vegas, NV11.2024
ASSOCIATE OF ARTS -
COLLEGE OF SOUTHERN NEVADA
Henderson, NV11.2023
Skills
- NAVINET
- OPTUM
- ECLINICALWORKS
- NORIDIAN MEDICARE PORTAL
- AVAILITY
- ADVANCEDMD
- THERABILL
- ZENITH DASHBOARD
- WEBPT
- ZELIS
- OFFICE
- Utilization Review
- Medical Terminology
- Medical Coding
- ICD-10
- Medical Billing
- Medical Office Experience
- Medical Scheduling
- Medical Records
- Hospital Experience
- EMR Systems
- Insurance Verification
- HIPAA
- CPT Coding
- ICD-9
- Epic
- Phone Etiquette
- Medical collection
- ICD coding
- Accounting
- Inovalon Software
- Wellsky Specialty
- Wellsky Rehabilitation
Certification
- CPR Certification
- BLS Certification
- Certified Professional Coder
- Certified Coding Associate
- Certified Medical Assistant
Assessments
- Analyzing data — Proficient
- August2022
- Interpreting and producing graphs, identifying trends, and drawing justifiable conclusions from data
- Full results: Proficient
- Call center customer service — Proficient
- June2021
- Demonstrating customer service skills in a call center setting
- Medical billing — Proficient
- July2022
- Understanding the procedures and forms used for medical billing
- Bookkeeping — Proficient
- Calculating and determining the accuracy of financial data
- Medical terminology — Proficient
- Understanding and using medical terminology
- Protecting patient privacy — Proficient
- May2024
- Understanding privacy rules and regulations associated with patient records
- June2022
- Customer focus & orientation — Proficient
- Responding to customer situations with sensitivity
- Attention to detail — Proficient
- Identifying differences in materials, following instructions, and detecting details among distracting information
- Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.
Timeline
Ar Specialists (Contract Position)
NOREMAC REIMBURSEMENT SOLUTIONS, LLC
03.2024 - 04.2024
Director of Ur & Billing
SIERRA SAGE RECOVERY SERVICES, LLC
04.2023 - 03.2024
Medical Assistant
MARILYN STRADA PHD, LLC
12.2020 - 09.2022
Medical Office Lead
BOTTOM LINE EXECUTIVES, INC
12.2019 - 04.2020
Member Service Representative
C3/ CUSTOMER CONTACT CHANNELS
06.2019 - 12.2019
Lead Billing Specialist
Post Acute Medical (PAM) Health
- Current
BACHELOR'S DEGREE - CRIMINAL JUSTICE
UNIVERSITY OF LAS VEGAS
ASSOCIATE OF ARTS -
COLLEGE OF SOUTHERN NEVADA