LauRay McLain
Topeka,KS
Summary
To secure a full-time position as a supervisor or manager for an established Medical Management Company.
Overview
11
11
years of professional experience
Work History
Billing & Authorization Specialist
Caregivers, Inc.
Topeka, KS
08.2022 - Current
- Processed verification of billing data for accuracy & revision of errors. Monitor AR aging reports & process information to guarantee payment of claims.
- Coordination & collection of necessary information from staff & payors for claim adjudication.
- Resolve discrepancies in accounting records & problem accounts.
- Executed billing tasks and recorded information in company databases.
- Kept all patient information secure and confidential.
- Followed up with appropriate parties to obtain prompt payments.
Provider Enrollment Specialist II
Medallion, Inc.
San Francisco, CA
11.2021 - 05.2022
- Prepared and processed provider enrollments with Medicare and Medicaid in multiple states.
- Used billing databases to enter provider effective dates into enrollment database.
- Monitored credentials and contacted practitioners when expiration dates were nearing.
- Conversed effectively with various parties on daily basis using polished interpersonal and active listening skills
- Communicated with people from various cultures and backgrounds on application process.
- Contacted insurance carriers to obtain information regarding denials.
- Documented application approvals with PTAN & effective dates.
Provider Enrollment Specialist II
Envision Healthcare
Topeka, KS
01.2018 - 11.2021
- Prepared and processed provider enrollments with Medicare and Medicaid in multiple states.
- Contacted insurance carriers to obtain information regarding denials.
- Conversed effectively with various parties on daily basis using polished interpersonal and active listening skills
- Monitored credentials and contacted practitioners when expiration dates were nearing.
- Communicated with people from various cultures and backgrounds on application process.
- Inputted all gathered information and researched data on applicants into computer system.
- Developed extensive fact-checking and research skills as result of continuously reviewing different programs and options.
Caseworker II/Estate Recovery
Total Clerical Services, Inc.
Boston, Mass
03.2016 - 03.2017
- Maintained high level of client confidentiality, following strict guidelines and recommendations.
- Probate and asset research & collection of deceased Medicaid recipients.
- Research via internet, phone calls, court documents, court staff, county tax offices & insurance adjusters.
Advanced Resolution Specialist II
General Dynamics Information Tech., Inc.
Lawrence, KS
01.2015 - 03.2016
- Drove dispute resolutions using effective problem-solving and by guiding mutual understanding of opposing viewpoints.
- Used mediation techniques to facilitate communication between disputants, to further parties' understanding of different perspectives and to guide parties toward mutual agreement.
- Formulated focused and individualized resolutions aimed to peacefully settle disputes.
- Prepared written opinions or decisions regarding cases.
- Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.
- Carried out day-day-day duties accurately and efficiently.
- Performed duties in accordance with applicable standards, policies and regulatory guidelines to promote safe working environment.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
Education
Associate of Applied Science - LPN
Kaw Area Technical School
Topeka, KS06.1996
Skills
- Communication
- I am an excellent communicator with superior interpersonal skills I have written winning and
- Published articles for the Topeka Capitol Journal as well as the KawVo-Tech newsletter I was asked to
- Prepare and deliver a speech for the all-school graduation I presented as the featured speaker for the
- Event
- Leadership
- I am a strong leader and enjoy developing skills within my team I am well versed in all clerical aspects
- Of the medical office & health care systems I have superior customer service skills and understand the
- Dynamics of quality service & care
- Customer Relationship Management
- Paperwork and Documentation
- Patient Interviews
- Specialist Procedures
- Operational Requirements
- Resource Information
- Call Control
- Referral Tracking
- Obtaining Authorizations
- Enrollment Procedures
- Call Transfers
- Telephone Etiquette
- Medicaid Management Information Systems (MMIS)
- Outbound Calls
- Office Supplies and Inventory
- Applicant Support and Service
- Application Assessments
- Eligibility Requirements
- Patient Contact
- Medical Terminology Knowledge
- Reviewing Patient Information
- Reading Comprehension
- Critical Thinking
- Program Knowledge
- Intakes and Assessments
Timeline
Billing & Authorization Specialist
Caregivers, Inc.
08.2022 - Current
Provider Enrollment Specialist II
Medallion, Inc.
11.2021 - 05.2022
Provider Enrollment Specialist II
Envision Healthcare
01.2018 - 11.2021
Caseworker II/Estate Recovery
Total Clerical Services, Inc.
03.2016 - 03.2017
Advanced Resolution Specialist II
General Dynamics Information Tech., Inc.
01.2015 - 03.2016
Associate of Applied Science - LPN
Kaw Area Technical School