LAVONNE CHAMBERS
Bedford,Ohio
Summary
Knowledgeable Billing Manager with solid background in managing billing operations and ensuring accuracy and efficiency. Successfully led teams to streamline processes and improve billing cycles. Demonstrated expertise in financial analysis and problem-solving.
Overview
42
42
years of professional experience
1
1
Certification
Work History
Billing Manager
Eyecare Partners
01.2012 - Current
- Manage a team of Billing Specialists and collaborate with the Management team and supported departments to accurately capture reimbursement opportunities, while providing extraordinary customer service
- Manage department, including problem solving, administering procedures to increase efficiencies, and implementing new systems to ensure accountability
- Oversees daily revenue cycle operations, including billing, collections, claims, and payments
- Manage billing, collections, claims processing, and payment posting
- Monitor and optimize key metrics (e.g., AR days, collection rates)
- Lead and train the revenue cycle team
- Ensure compliance with healthcare billing standards and regulations
- EFT/ERA set-up
- Ensure claims are correctly submitted and denials are appealed and resubmitted within the timeframe for filing consideration
- Manage the investigation and resolution of billing discrepancies and errors
- Supervise billing and collections processes to guarantee optimization in work-flow
- Review unpaid patient balances and establish payment arrangements
- Assist with billing, AR, payment posting, collections and other department functions as needed
- Generate standard reports, and reviews each for accuracy and consistency with the billing system(s)
- Monitor monthly payment collections by payer to eliminate potential payer issues
- Maintains and ensures compliance to regulatory standards
- Abide by HIPAA standards and requirements
Medical Billing / A R Specialist
New Directions
01.2010 - 11.2011
- Responsible for weekly billing of UB04 facility billing for third party payers via the claims clearing house and paper as needed
- Reviewed and processed all professional claims on HCFA 1500 claims via paper and clearing house for third party payers
- Review and follow up on all insurance correspondence received which include authorizations, denials and $0 pay claims
- Maintained client accounts and mailed client statements
- Prepared required documentation of delinquent client’s accounts in order to forward to the collection company
- Assisted the clinical staff with referrals to ensure all services were authorized and pre-carted as needed
Medical Biller/Patient Account Representative
Human Arc
08.2007 - 11.2009
- Responsible for weekly billing of HCFA 1500 for third party payers via the claims clearing house and paper as needed
- Responsible for processing and posting all payments received from various insurance companies
- Intermediate understanding of Explanation of Benefits form (EOB), Managed Care Contracts
- Review and follow up on all insurance correspondence received which include authorizations, denials and $0 pay claims
- Handles all request regarding account and remittance balancing
- Followed up with insurance companies for claim status
Unit Leader-patient accounts
Receivable Outsourcing
12.2004 - 06.2007
- Responsible for various assignments with a concentration of monitoring the follow up staff to ensure that claims are processed according to the benefit plan of various insurance companies
- Responsible for all financial functions related to subscriber and provider distribution of funds from the various insurance companies
- Handles all request regarding account and remittance balancing
- Monitoring of the billing staff to ensure all claims are submitted accurately and timely
- Maintain aging reports of the follow-up staff and billing staff to ensure that all processing is being handled timely
- Updates productivity and quality of all staff monthly
- Train all new hires for follow-up and billing positions
Claims Supervisor
Central Reserve Life
12.2000 - 01.2004
- Responsible for examiners who investigate and process claims submitted
- Motivate personnel to maintain production and quality standards
- Monitored each employees claim production and accuracy
- Provided monthly reports to employees to give direction and to help improve in needed areas
Adjustment Supervisor
QualChoice Health Plan
01.1995 - 05.2000
- Responsible for various assignments with a concentration in the claims adjustment areas requiring understanding of group plans and company policies and procedures
- Responsible for all financial functions related to subscriber and provider distribution of funds
- Handles all request regarding account and remittance balancing
- Provides appropriate direction of all refund checks and company checks, applying them to various accounts and provider files
Adjustment Analyst/Customer Service Rep.
QualChoice Health Plan
02.1991 - 01.1995
- Responded to request from customer service, marketing and provider relations regarding claims adjudication
- Recovered funds through provider returns while maintaining quality and production standards
- Assisted with claims processing in other areas when needed
- Approved and denied payments according to benefit contracts
Medical Biller
Medical Mutual
03.1983 - 01.1991
- Responsible for weekly billing of HCFA 1500 for third party payers via the claims clearing house and paper as needed
- Responsible for processing and posting all payments received from various insurance companies
- Review and follow up on all insurance correspondence received which include authorizations, denials and $0 pay claims
- Handles all request regarding account and remittance balancing
- Followed up with insurance companies for claim status
Education
High School Diploma -
Shaw High School
E. Cleveland OHIO06-1982
Skills
- Accounts receivable management
- Collections experience
- Training and mentoring
- ICD 10 & CPT Coding
References
References furnished upon request
Certification
Certificate completion for OSHA,Ethics & Code of Conduct, Preventing Harassment & Discrimination, Information Security, Combating Fraud, and HIPAA.
Timeline
Billing Manager
Eyecare Partners
01.2012 - Current
Medical Billing / A R Specialist
New Directions
01.2010 - 11.2011
Medical Biller/Patient Account Representative
Human Arc
08.2007 - 11.2009
Unit Leader-patient accounts
Receivable Outsourcing
12.2004 - 06.2007
Claims Supervisor
Central Reserve Life
12.2000 - 01.2004
Adjustment Supervisor
QualChoice Health Plan
01.1995 - 05.2000
Adjustment Analyst/Customer Service Rep.
QualChoice Health Plan
02.1991 - 01.1995
Medical Biller
Medical Mutual
03.1983 - 01.1991
Certificate completion for OSHA,Ethics & Code of Conduct, Preventing Harassment & Discrimination, Information Security, Combating Fraud, and HIPAA.
High School Diploma -
Shaw High School
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