Lee Barnable
Ringwood,NJ
Summary
Proven Appeal Coordinator at Med Metrix, adept in policy interpretation and effective communication, enhanced appeal resolution rates significantly. Demonstrated expertise in regulatory compliance and process improvement, showcasing strong analytical skills and attention to detail. Excelled in a team-oriented environment, driving quality and efficiency across multiple roles in healthcare administration.
Overview
5
5
years of professional experience
Work History
Appeal Coordinator
Med Metrix
04.2024 - Current
- Created, composed and maintained appeal response templates.
- Coordinated with senior specialist to compose appeal responses.
- Enhanced appeal resolution rates by thoroughly reviewing and analyzing case documentation.
- Implemented process improvements based on audit findings, enhancing overall quality and efficiency within the department.
- Maintained comprehensive knowledge of regulatory guidelines to ensure compliance within the appeals department.
Dental Billing Specialist
Max Oral Surgery
04.2023 - 04.2024
- Enhanced revenue collection rates by diligently monitoring outstanding accounts, initiating timely follow-ups, and negotiating payment plans with patients.
- Streamlined pre-authorization processes for complex dental procedures, ensuring timely insurance approvals and minimizing treatment delays.
- Coordinated with other team members to resolve any scheduling conflicts or miscommunications that could impact billing processes or patient satisfaction.
- Maintained a comprehensive understanding of dental procedures and terminology, enabling clear communication with both patients and insurance companies regarding billing matters.
- Developed efficient billing processes for faster insurance claim submissions, reducing errors and speeding up reimbursement times.
Patient Case Coordinator
Caresphere
04.2022 - 12.2022
- Ensured accurate record-keeping for seamless case management by diligently updating electronic health records systems with relevant patient data.
- Collaborated with multidisciplinary teams to develop personalized care plans that addressed individual patient needs and preferences.
- Demonstrated empathy towards patients experiencing challenging life events while collaborating closely with social workers to address non-medical issues impacting their wellbeing.
- Educated patients on preventative measures and self-care strategies, empowering them to take greater ownership over their health outcomes.
- Enabled swift access to critical care services for time-sensitive cases by prioritizing urgent referrals based on clinical assessment criteria.
Medical Billing Specialist
Aspirion Health Resources
03.2020 - 04.2022
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted and adjusted payments from insurance companies.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Located errors and promptly refiled rejected claims.
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- Identified and resolved patient billing and payment issues.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
Education
High School Diploma -
Lakeland Regional High School
Wanaque, NJSkills
- Data entry proficiency
- Policy interpretation
- Confidentiality
- Insurance regulations
- HIPAA compliance
- Effective communication
- Strong analytical skills
- Medical terminology
- Documentation expertise
- Insurance policies
- Teamwork
- Multitasking skills
- Attention to detail
Timeline
Appeal Coordinator
Med Metrix
04.2024 - Current
Dental Billing Specialist
Max Oral Surgery
04.2023 - 04.2024
Patient Case Coordinator
Caresphere
04.2022 - 12.2022
Medical Billing Specialist
Aspirion Health Resources
03.2020 - 04.2022
High School Diploma -
Lakeland Regional High School
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