Job Search Status
Open to workDesired start date: 2 weeks notice
Open To Work
LaShawn Rudolph
Oak Park,USA
Work Preference
Summary
Detail-oriented Medical Billing Specialist with 25+ years of experience in accurate billing, insurance claim processing, and revenue cycle management. Proficient in ICD-10 and CPT coding, as well as Epic billing system. Skilled in maximizing reimbursements and resolving billing discrepancies
Overview
25
25
years of professional experience
Work History
Claims Analyst
Robert Half Temp Service (McLaren Hospital)
Flint, MI
08.2025 - Current
- Analyzed complex pathology reports to determine appropriate ICD-10-CM codes to high risk, neoplastic disease.
- Emphasize accuracy when translating pathology findings to ensure proper coding.
- Abstracting findings from pathology reports to determine accurate codes.
- Proficiently utilized online coding tools (ICD-10-CM) to accurately assign diagnosis codes for surgical and pathology reports, improving billing accuracy.
Follow-up and Denials Representative
Corewell Health
06.2015 - 02.2025
- Analyzed billing discrepancies to streamline reconciliation processes and reduce errors.
- Verified patient insurance eligibility and coverage details
- Resolved claim denials and billing errors
- Processed insurance claims and appeals
- Facilitated patient communication by addressing inquiries and providing information on services.
- Utilized electronic health record systems to maintain accurate patient data and ensure compliance with regulations.
- Managed insurance claim follow-ups, ensuring timely resolution of outstanding accounts.
- Collaborated with healthcare providers to verify patient insurance coverage and benefits.
- Analyzed denial patterns regularly to develop targeted strategies for reducing claim rejections.
Medical Claims Analyst
HAP
11.2013 - 01.2015
- Processed adjustments and provider refunds received via mail from medical providers and members
- Process Pega claim cases from customer service inquiries.
- Review and process EOB's and initiate appeals as necessary
- Verification of status of pending claims and approximate dates of upcoming payments
- Read and assessed medical documents and records to ensure proper billing for claim submission
Medical Information Specialist
Blue Cross Blue Shield
10.2010 - 08.2013
- Provide through analysis and investigation of authorization request for specialized services, which include medical/surgical, ambulatory outpatient procedure codes in an expeditious and accurate manner.
- Prepare information and assistance as it pertains to the Medical Management program to providers
- Worked to resolve pending claims and inquiries supported by adequate medical documentation, forward to the appropriate department
- Coordinated patient referrals to specialists, ensuring timely and accurate processing of requests.
- Verified insurance benefits and eligibility for various procedures before referring clients.
Education
Associate of Science - Medical Office Administration
Lewis College of Business
Detroit,MI08-2000
Skills
- Expertise in hospital billing, physician billing and specialty-specific coding
- Knowledge of medical billing and coding (ICD-10, CPT), experience with billing software (Epic), and ability to manage insurance claims and patient accounts
- Knowledge of HIPPA and other relevant regulations, ability to ensure compliance in billing practices
- Certified Revenue Cycle Representative (CRCR) certification
- Claims
Timeline
Claims Analyst
Robert Half Temp Service (McLaren Hospital)
08.2025 - Current
Follow-up and Denials Representative
Corewell Health
06.2015 - 02.2025
Medical Claims Analyst
HAP
11.2013 - 01.2015
Medical Information Specialist
Blue Cross Blue Shield
10.2010 - 08.2013
Associate of Science - Medical Office Administration
Lewis College of Business