Lasha Fowler
Summary
Medical billing professional with deep expertise in managing patient billing and insurance claims. Strong background in billing, account reconciliation, and compliance with healthcare regulations. Known for collaborating effectively with teams and adapting to changing needs to achieve optimal results. Reliable and detail-focused, ensuring accurate and timely processing of financial information.
Overview
21
21
years of professional experience
Work History
Senior Caregiver
Cornerstone Health Care
08.2024 - Current
- Maintained clean, safe, and well-organized patient environment.
- Offered companionship and kindness to elderly patients.
- Assisted patients with daily living activities, ensuring their safety and wellbeing.
- Assisted in maintaining a clean and safe environment for patients, completing housekeeping tasks as needed.
- Assisted clients with daily living needs to maintain self-esteem and general wellness.
- Maintained accurate documentation of patient care activities for regulatory compliance purposes.
Claims Adjudicator/Medical Billing
Evolent Health
09.2019 - 12.2024
- Navigates strategically through medical claims problem solving and using independent judgment to analytically come to a resolution
- Accurately reads and understands the content of UB-04, CMS1500 form, COB and EOBs
- Resubmitting denial claims for primary or secondary payment
- Consolidate claims Work high volume of repetitive claims
- Maintain productivity goals, quality standards and aging timeframes
- Developed training materials for new hires to onboard them effectively into the role of Claims Adjudicator.
- Enhanced customer satisfaction by providing timely and accurate claims decisions, while maintaining open lines of communication with policyholders.
Claims Adjudicator/Medical Billing
Randstad Staffing Services
12.2018 - 06.2019
- Navigates strategically through medical claims problem solving and using independent judgment to analytically come to a resolution
- Accurately reads and understands the content of UB-04, CMS1500 form, COB and EOBs
- Resubmitting denial claims for primary or secondary payment
- Consolidate claims Work high volume of repetitive claims
- Maintain productivity goals, quality standards and aging timeframes
- Consistently met or exceeded performance targets for claims processing and adjudication, contributing to overall departmental success.
Claims Processor
Firstsource Transaction Services, LLC
04.2012 - 12.2018
- Navigates strategically through medical claims problem solving and using independent judgment to analytically come to a resolution
- Comprehensive knowledge of the following classification systems: current versions of International Classification of Diseases (ICD-10), Current Procedural Technology (CPT) and Healthcare Common Procedure Coding System (HCPCS), with skill in applying said classifications based on health record documentation
- Responsible for communicating with clinical staff resolve specific coding and documentation issues
- Accurately reads and understands the content of medical records, medical terminology and significant comments
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies
- Collaborated with cross-functional teams to resolve complex claims issues efficiently and effectively.
Janitor/Custodian
Kimco Cleaning Services
05.2017 - 08.2018
- Clean floors by sweeping mopping, scrubbing, or vacuuming
- Maintain safety procedures by handling cleaning equipment and supplies according to company protocols
- Cleaning and stocking restrooms, breakrooms
- Performing such tasks as locking doors after operating hours
Provider Enrollment Representative 1
National Government Services
10.2010 - 10.2011
- Ensured accurate entry of data into Centers for Medicare and Medicaid Services (CMS) national databases
- Processed initial applications, information updates for existing providers, and electronic funds transfers.
- Reviewed agreement between CMS and the Federally Qualified Health Centers (FQHC).
- Determined or forwarded recommendations for the outcome of the enrollment applications to CMS and state agencies.
- Validated the accuracy of data submitted
- Input accurate payment details and managed reports in Facets or Qnxt 5.1
Medical Billing Specialist
National Government Services, Inc
06.2009 - 10.2010
- Coded and processed claim forms for payment ensuring all information is supplied before eligible payments are made.
- Researched and analyzed claim issues.
- Experienced with Microsoft software and database systems
- Located errors and promptly refiled rejected claims.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Posted and adjusted payments from insurance companies.
Data Management Clerk
Kelly Services
09.2008 - 01.2009
- Processed accurate claims for payment
- Researched information on claims was correctly being entered into the database
- Researched ICD-9 Diagnosis codes correctly with proper documentation
- Reduced errors in data entry by carefully inputting information into computer systems with attention to detail.
- Utilized strong multitasking skills to manage multiple priorities and tasks, ensuring timely completion of each assignment.
Machine Operator
Deco Paper Products
07.2004 - 09.2008
- Responsible for setting up and operating an extrusion machine in accordance with established procedures, guidelines, and customer requirements
- Kept records of approved and defective units or final products
- Controlled and adjusted machine setting for quality control
- Followed detailed instructions to operate machines with accuracy and produce quality products.
- Complied with company and OSHA safety rules and regulations.
Education
Associate's degree - medical professional Coding
ATA Educational College
Louisville, KY12.2009
Skills
- Microsoft Word
- Data Entry
- Compassionate care
- Goal oriented
- Claims processing
- Payment posting
Timeline
Senior Caregiver
Cornerstone Health Care
08.2024 - Current
Claims Adjudicator/Medical Billing
Evolent Health
09.2019 - 12.2024
Claims Adjudicator/Medical Billing
Randstad Staffing Services
12.2018 - 06.2019
Janitor/Custodian
Kimco Cleaning Services
05.2017 - 08.2018
Claims Processor
Firstsource Transaction Services, LLC
04.2012 - 12.2018
Provider Enrollment Representative 1
National Government Services
10.2010 - 10.2011
Medical Billing Specialist
National Government Services, Inc
06.2009 - 10.2010
Data Management Clerk
Kelly Services
09.2008 - 01.2009
Machine Operator
Deco Paper Products
07.2004 - 09.2008
Associate's degree - medical professional Coding
ATA Educational College
Similar Profiles
JACOB ELLINGTONJACOB ELLINGTON
Caregiver at Cornerstone Health CareCaregiver at Cornerstone Health Care
Shonna M AllenShonna M Allen
In Home Caregiver at Cornerstone Health CareIn Home Caregiver at Cornerstone Health Care
Nicole Leon JaramilloNicole Leon Jaramillo
Senior Caregiver at Cornerstone Health CareSenior Caregiver at Cornerstone Health Care
Diana PaulDiana Paul
Senior Caregiver at Sunrise Assisted LivingSenior Caregiver at Sunrise Assisted Living
Alishia MarcelleAlishia Marcelle
Senior Caregiver at Comfort KeepersSenior Caregiver at Comfort Keepers