Summary
Overview
Work History
Education
Skills
Timeline
Generic
Lesa Leverett

Lesa Leverett

Grand Rapids

Summary

Resourceful Supervisor trained in resolution of critical issues within time-sensitive environment with successful track record of building and maintaining talented teams. Highly organized, energetic and versatile leader committed to continuous improvements. Proven history of motivating staff to work together to achieve targets.

Overview

14
14
years of professional experience

Work History

Supervisor, Payment Resolution (Medicaid Advantage/Medicaid)

Trinity Health
11.2023 - Current
  • I have comprehensive knowledge of revenue cycle functions and systems, specifically experience with Denials and other functions related to revenue cycle activities.
  • Prepare metrics and summaries for Managed Medicaid and traditional Medicaid for the manager and director.
  • Track all trends for the cause of denials and make recommendations on the findings to the manager and Director.
  • Responsible in reviewing and approving all adjustments for the colleagues under a specific financial class.
  • Provide direct individual and team leadership; schedule and facilitate team meetings. Provide one on one coaching sessions with associates. Manage productivity and quality to each associate.
  • Manage time off requests and time sheets.
  • Review performance standards for colleagues and provide feedback to achieve performance improvement.
  • I maintain a working knowledge of applicable Federal, State and local laws and regulations, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical and professional behavior.
  • Proficient in Microsoft Office, Outlook, Word, PowerPoint and Excel.
  • Full time employee, 40 hours a week.

Payment Resolution Specialist II

Trinity Health
10.2019 - 11.2023
  • Serve as part of the Payment Resolution Team for a specific assigned location responsible for ensuring payments are received on denied accounts, determining root causes for discrepancies, minimizing inappropriate payment delays and variances from expected reimbursement, and resolving or escalating issues to the Supervisor Payment Resolution for resolution.
  • I have the knowledge of specific payer payment rules and regulations, managed care contracts, reimbursement schedules, eligible provider information and other available data and resources in order to research payment delays and variances, make corrections, and take appropriate corrective action to ensure timely claim resolution.
  • I maintain working knowledge of payer contracts and payer payment rules.
  • I worked special reports for management to inform management as well as colleagues the different types of denials as well as the root cause to help make recommendations for improvements.
  • I have had the opportunity to train new colleagues as well as veteran colleagues in the denials processes.
  • I run question & review time twice a week, to help colleagues resolve accounts.
  • I feel as though I have worked extremely hard on learning all aspects of the denial process. In return, I believe I am an associate that other associates can come to me with issues, and I can direct them in the right direction.
  • Full time employee, 40 hours a week.

Insurance Verification Specialist

Advanced Radiology Specialists
07.2019 - 10.2019
  • Use of multiple insurance & hospital data bases to obtain patient eligibility.
  • Research claim rejections, update and correct patient insurance information to rebill claims.
  • Update and correct insurance information to patient accounts regarding incoming charges.
  • Research, review and correct insurance claims to ensure timely and accurate claims.
  • Effectively communicate with co-workers, making sound decisions, timely and independently.
  • Proficient in Medical Terminology and HIPAA regulations.
  • Proficient in CPT, ICD-10, revenue codes and modifiers.
  • Proficient in Ambulatory Payment classification and Outpatient Prospective Payment system.
  • Regular use of Microsoft Word, Outlook and Excel and other general administrative support activities.
  • Full time employee, 40 hours a week.

Scheduling/Insurance Coordinator

Michigan Surgical Center
05.2017 - 05.2019
  • Use of multiple insurance data bases to obtain patient eligibility as well as co-pays, co-insurance and deductibles.
  • Called multiple insurance companies to collect patient information as needed for prior authorizations & co-pay amount.
  • Prepared and sent out Patient Responsibility Letters to patients as needed to collect co-pays and co-insurance.
  • Worked with multiple providers to schedule surgeries.
  • Entered patient/surgery information in data base.
  • Answered multi phone lines as needed.
  • Regular use of Microsoft Office.
  • Per Diem, as needed.

Lead Review Specialist

Inovalon
07.2011 - 04.2017
  • Project Management; (HEDIS, NCQA and RAC) Process, track and monitor client requests to ensure project completion.
  • Assigned daily work assignments to associates.
  • Managed communication and correspondence with provider offices, clients and other internal and external personnel, which included travel reviews.
  • Managed; included but was not limited to, organizing and producing documents, maintaining filing systems, meet weekly, monthly and quarterly deadlines.
  • Provided direct individual and team leadership; scheduled and facilitated team meetings. Provided one on one coaching sessions with associates. Managed productivity and quality to each associate. Managed time off requests and time sheets.
  • Team player; Motivated, promoted and encouraged the building of talent for associates.
  • Processed, tracked and monitored client requests of medical records.
  • Effectively communicated with staff at all times with sound decisions, timely and independently.
  • Monitored and managed electronic data using multiple systems.
  • Scheduled onsite medical reviews and conference calls for the Site Review Consultants or other field review staff.
  • Maintained schedules for field reviewers completing on site visits, maintain electronic filing system, and composed correspondence to internal and external customers.
  • Documented a high volume of medical records, making updates to a large electronic database of information which is imperative to be proficient in Medical Terminology and HIPAA regulations.
  • Regular use of Microsoft Word, Outlook and Excel and other general administrative support activities.
  • Full time employee, 40 hours a week.

Education

EMT License - Emergency Medicine

Windsor Township
Dimondale, MI
01-1999

Associate of Science - Dental Assistant

Lansing Community College
Lansing, MI
05-1998

Some College (No Degree) - Nursing

Baker College
Owosso, MI

Skills

  • Revenue cycle management
  • Team leadership
  • Medical terminology
  • Training and development
  • Effective communication
  • Problem solving
  • Root cause analysis
  • Microsoft Excel
  • Relationship building
  • Staff development
  • Team building
  • Staff education
  • Verbal and written communication
  • Data analytics
  • Payroll processing
  • Performance management
  • Attention to detail
  • Task delegation
  • Policy and procedure development
  • Conflict resolution
  • Staff discipline
  • Processes and procedures
  • Employee motivation
  • Customer service
  • Microaoft experience
  • Coaching and mentoring
  • Quality control
  • Project management

Timeline

Supervisor, Payment Resolution (Medicaid Advantage/Medicaid)

Trinity Health
11.2023 - Current

Payment Resolution Specialist II

Trinity Health
10.2019 - 11.2023

Insurance Verification Specialist

Advanced Radiology Specialists
07.2019 - 10.2019

Scheduling/Insurance Coordinator

Michigan Surgical Center
05.2017 - 05.2019

Lead Review Specialist

Inovalon
07.2011 - 04.2017

EMT License - Emergency Medicine

Windsor Township

Associate of Science - Dental Assistant

Lansing Community College

Some College (No Degree) - Nursing

Baker College

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