Summary
Overview
Work History
Education
Skills
Additional Information
Timeline
Generic

Lauren Woebse

Highland

Summary

Polished and hardworking professional with several years experience in fast-paced, multiple-client medical billing company serving multiple counties. Proficient in submitting medical claims and processing appeals for denied claims. Familiar with healthcare billing, coding and collections.

Overview

9
9
years of professional experience

Work History

Patient Care Coordinator

OptumRx
10.2024 - Current
  • Managed sensitive patient information with strict adherence to HIPAA guidelines, maintaining confidentiality and privacy at all times.
  • Provided exceptional customer service by addressing concerns, answering questions, and ensuring patient satisfaction with successfully scheduling deliveries of specialized medication and oncology medication.
  • Enhanced patient satisfaction with contacting doctor offices to initiate prior authorizations.
  • Streamlined communication between patients and healthcare providers, ensuring timely responses to inquiries and concerns.

Collector Physician Billing

Optum
04.2022 - 10.2024
  • Proficient in EPIC Software
  • Obtain claim statuses from multiple Insurance carriers; utilizing payer portals and callings Insurance carriers
  • Submit claims and appeals directly to multiple Insurance Carriers for reimbursement
  • Efficiently worked claims for Medicare, Medicare Advantage Plans, NY Medicaid, Veterans Administration and Commercial Secondary Insurances.
  • Investigated disputes raised by customers concerning billing errors or incorrect charges.
  • Collaborated with multidisciplinary teams including Medical Coding, Customer Service Agents and Accounts Receivable, to ensure optimal patient outcomes.
  • Performed data entry tasks related to invoicing, billing, order processing.

Billing Account Representative

Mobile Life Support Services
11.2015 - 04.2022
  • Accurately code and submit claims for reimbursement to Medicare
  • File First and Second Level Appeals electronically to Medicare for claims incorrectly denied for reimbursement
  • Identify and rectify overpayments made by Medicare on claims
  • Researched CPT and ICD- 10 coding discrepancies for compliance and reimbursement accuracy.
  • Communicated effectively and extensively with other departments to resolve claims issues.
  • Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments.
  • Complied with all HIPAA Privacy and Security Regulations to protect patients' medical records and information.
  • Filed and updated patient information and medical records.
  • Prepared billing statements for patients and verified correct diagnostic coding.
  • Assisted patients by determining financial assistance available and setting up payment plans.

Education

Bachelor of Science - Childhood Education

SUNY College At Oswego
Oswego, NY
05.2011

Certified Ambulance Coder -

National Academy Of Ambulance Compliance
10.2017

Certified Ambulance Documentation Specialist -

National Academy Of Ambulance Complicance
10.2019

Skills

  • Medical Coding
  • Medical Records Review
  • Patient Contact
  • Claims Adjustments
  • HIPAA Compliance

Additional Information

References:

Julia Raudibaugh - Optum

Team Leader Team Leader (607) 435-3580

julia.raudibaugh@optum.com


Rebecca Baker - Optum

General Manager OI Operations

(607) 547-6591 rebecca.baker@optum.com


Breana Rivera; Former coworker 845 625 7306


Timeline

Patient Care Coordinator

OptumRx
10.2024 - Current

Collector Physician Billing

Optum
04.2022 - 10.2024

Billing Account Representative

Mobile Life Support Services
11.2015 - 04.2022

Bachelor of Science - Childhood Education

SUNY College At Oswego

Certified Ambulance Coder -

National Academy Of Ambulance Compliance

Certified Ambulance Documentation Specialist -

National Academy Of Ambulance Complicance

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Lauren Woebse