Layce Dux
Crete,NE
Summary
Versatile Billing Coordinator bringing 10 years of healthcare experience. Familiar with confidentiality requirements, patient care standards, insurance and billing claims processes. Flexible, reliable and goal-driven.
Overview
10
10
years of professional experience
Work History
Billing and Authorization Lead
Nebraska Hematology Oncology
03.2022 - Current
- Determined prior authorizations for medication and outpatient procedures.
- Pre-certified medical and radiology procedures and chemotherapy treatment plans.
- Identified and resolved patient billing and payment issues.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Trained and mentored new team members and department managers.
- Daily use of Unlimited Systems and I Know Med electronic medical records systems.
Billing Coordinator
Rheumatology & Osteoporosis Services
05.2021 - 02.2022
- Contacted clients with past due accounts to formulate payment plans and discuss repayment options.
- Entered details into accounts and tracked payments.
- Completed appeals of denied claims on patient bills.
- Connected patients with available community and charitable resources to assist in payment of high dollar medications.
- Reviewed on average 300 patient cases per week and verified insurance coverage information.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Answered central telephone system and directed calls accordingly.
- Confirmed appointments, communicated with clients and updated client records.
Medical Coding and Billing Specialist
Urology PC
9 2020 - 05.2021
- Interacted and communicated easily with department personnel and public.
- Used AMA CPT and ICD-10 coding manuals to gain additional knowledge of disease and diagnoses processes.
- Developed and maintained courteous and effective working relationships.
- Reviewed patient charts to better understand health histories, diagnoses and treatments.
Infusion and Billing Coordinator
Gastroenterology Specialties PC
09.2014 - 09.2020
- Determined prior authorizations for medication and outpatient procedures.
- Assisted patients by determining financial assistance programs available and setting up payment plans.
- Researched and followed up on denied insurance claims.
- Documents clear, concise, and complete account notes on patient accounts regarding patient benefit eligibility and claim status.
- Interacted and communicated easily with department personnel and public.
- On a case by case basis, worked with a number of drug companies and regional managers to insure coverage of infusion and injectable medications for patients who were under insured or medical necessity dictated use of medication outside package insert.
- Answered telephone and in person inquiries with friendly demeanor and full knowledge of billing department processes.
- Maintained detailed understanding of insurance plans and company requirements.
- Completed appeals of denied claims on patient bills.
- Reviewed and solved account and billing discrepancies.
- Accurately posted insurance payments from EFT payments as well as paper checks and electronic card payments.
Education
No Degree - Cosmetology And Barber License
College Of Hair Design
LincolnHigh School Diploma -
Tri County Jr-Sr High School
Dewitt, NE05.2002
Skills
- Insurance Knowledge
- Insurance Benefits and Coverage Verification
- Customer Inquiries
- Medical Prior Authorizations
- Accurate Payment Posting
- Payment Processing
- Medical Claims Coding
- Medical Records Review
- Training and Development
Timeline
Billing and Authorization Lead
Nebraska Hematology Oncology
03.2022 - Current
Billing Coordinator
Rheumatology & Osteoporosis Services
05.2021 - 02.2022
Infusion and Billing Coordinator
Gastroenterology Specialties PC
09.2014 - 09.2020
Medical Coding and Billing Specialist
Urology PC
9 2020 - 05.2021
No Degree - Cosmetology And Barber License
College Of Hair Design
High School Diploma -
Tri County Jr-Sr High School
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