Laurie Roe
St. Augustine,FL
Summary
Multi-talented Business & Claims Manager, consistently rewarded for success in planning and operational improvements. Experience in policy development and staff management procedures, which positively impact overall morale and productivity.
Overview
32
32
years of professional experience
Work History
Claims Examiner
Coventry CareLink Insurance Services LLC
Remote
08.2010 - Current
- Reviewed insurance policies to ascertain levels of coverage and adjudicate claims payment to policyholder or provider of care.
- Delivered exceptional customer service to policyholders and providers, by communicating important information and patiently listening to all issues.
- Drove operational improvements which resulted in savings and improved profit margins.
- Developed team communications and information for staff meetings, including claims procedures.
Account Executive/Assistant V.P.
Riggs, Counselman, Michaels, & Downes, Inc.
Towson, MD
04.2000 - 08.2006
- Acted as a Benefits Consultant to design benefits packages for large group clients of over 100 employees by establishing organization's needs, identifying budgetary limitations and proposing innovative methods to cut costs.
- Wrote RFP’s to market coverage to insurance carriers.
- Conducted in-depth contract review. Negotiated, prepared, & presented insurance contracts to clients.
- Led benefit plan implementations, involving 12 regional health systems.
- Monitored compliance issues.
- Managed vendor relationships.
- Pursued additional sales opportunities, based on client objectives.
Business Manager
Mid-Atlantic Network For Physical Therapy
Baltimore, MD
11.1994 - 04.2000
- Managed high-volume day-to-day business operations of TPA by recruiting & hiring 15-20 employees to administer billing, collections, credentialing, payment posting, provider payments, & customer service for 100 offices in Mid- Atlantic region (8,000 patient visits per month).
- Led team that reduced Aged Accounts Receivables by 70% in one year.
- Managed the business operations of 3 off-site rehabilitation clinics.
- Analyzed the financial & operational impacts of managed care contracts.
- Projected & reported sales, net revenue, and cash collections.
Patient Accounting Lead/Representative
Glass Mental Health Centers
Baltimore, MD
07.1993 - 11.1994
- Directed the outpatient billing department of 5 employees to complete monthly billing cycle.
- Monitored & reported Accounts Receivable trends each month.
- Handled utilization reports, referrals, and treatment plans for HMO accounts.
- Managed cash receipts & made timely deposits for 6 company entities.
- Handled inquiries & financial complaints for mental health patients.
Personnel Manager/Assistant Sales Manager
G&B Promotions Inc.
Baltimore, MD
05.1992 - 07.1993
- Recruited, interviewed, and managed a high volume of manager trainees.
- Conducted new hire orientations, as well as motivational meetings.
- Handled accounts receivables, personnel files, & management reports.
- Marketed & sold commercial art by traveling & cold-calling on businesses.
Education
Bachelor of Science - Business Administration - Management
Towson State University
Baltimore, MD05-1992
Skills
- Operations workflow & management
- Contract reviews and edits
- Vendor relations
- Accounts Payable and Accounts Receivable
- Claims Understanding
- Spreadsheet Tracking
- Past Due Balance Management
- Coverage Analysis
- Microsoft Office Suite
- Determine Coverage
- Benefits Review
- Authorize Payments
Timeline
Claims Examiner
Coventry CareLink Insurance Services LLC
08.2010 - Current
Account Executive/Assistant V.P.
Riggs, Counselman, Michaels, & Downes, Inc.
04.2000 - 08.2006
Business Manager
Mid-Atlantic Network For Physical Therapy
11.1994 - 04.2000
Patient Accounting Lead/Representative
Glass Mental Health Centers
07.1993 - 11.1994
Personnel Manager/Assistant Sales Manager
G&B Promotions Inc.
05.1992 - 07.1993
Bachelor of Science - Business Administration - Management
Towson State University