Lesley Morgan
Lake Worth,FL
Summary
Dedicated Healthcare Insurance professional with a history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
22
22
years of professional experience
Work History
Senior Manager, Insurance Services Department
MDVIP, Inc.
2011.08 - 2021.03
- Developed strong relationships with national based primary care physicians, insurance carriers, IPA/PHO and ACO's, ensuring long-term partnerships.
- Used industry expertise, customer service skills and analytical nature to resolve customer concerns and promote loyalty.
- Used strong analytical and problem-solving skills to develop effective solutions for challenging situations.
- Provided affiliated physicians with appeals to contracting disputes to ensure positive results. Resulting in a 98% in-network status nationally.
- Utilized data-driven insights to make informed decisions regarding prospect physician transitions to result in higher returns on investment in MDVIP Program.
- Provided on-hand assistance/mentoring to affiliated physicians on appeal hearings to ensure favorable results.
- Assisted affiliated physicians with negotiating contracting terms and/or new contracts with IPA/PHO and ACO's.
- Proficient in credentialing/provider enrollment procedures with commercial insurance, Medicare and Medicaid utilizing CAQH, PECOS, NPI and PTAN platforms.
- Provided training to affiliated physicians on process for MIPS reporting.
- Provided training to prospect physician and their office staff on MDVIP Program details to ensure a seamless transition.
- Provided training to physicians on standard billing practices for Medicare and commercial insurance lines.
- Provided physicians with updates and billing practices for Medicare and commercial insurance on COVID-19 billing practices.
- Worked with Athena, physicians and their office staff in transitioning to Athena platform.
- Implemented and developed operational standards, policies and procedures.
- Achieved operational excellence by streamlining processes and implementing best practices.
Administrator, Insurance and Billing Department
Simplex Healthcare
2008.06 - 2011.06
- Served as a liaison between departments, fostering open communication channels that improved overall organizational function.
- Collected, arranged, and input information into database system.
- Cultivated positive relationships with customers to deliver timely and cost-effective supply of services and materials.
- Computerized office activities, maintained customer communications, and tracked records through delivery.
- Increased customer satisfaction by addressing problems head-on through the use of seamless communication.
- Managed office inventory levels, ensuring adequate supplies were available while minimizing waste and unnecessary spending.
- Handled sensitive information discreetly, maintaining strict confidentiality at all times as required by company policy or legal regulations.
- Commercial insurance and Medicare benefit verification to ensure DME availability and coverage.
- Responsible for tracking account receivables.
- Recognizing any account receivable discrepancies and providing timely remediation.
- Assisted with Medicare auditing procedures.
- Provider credentialing and enrollment verification.
- Responsible for ensuring of the processing of clean claims per timely filing guidelines.
Office Manager
Liberty Landscape Lighting, LLC
2001.09 - 2008.04
- Handled sensitive information with discretion, maintaining confidentiality of company documents and personnel records.
- Developed and maintained successful relationships with vendors, suppliers and contractors.
- Updated reports, managed accounts, and generated reports for company database.
- Coordinated special projects and managed schedules.
- Developed and maintained courteous and effective working relationships.
- Maintained accurate financial records by reconciling accounts payable/receivable transactions regularly to ensure balanced budgets.
- Provided exceptional customer service when addressing client inquiries or concerns via phone calls or email correspondence.
- Managed office operations while scheduling appointments for department managers.
- Maintained computer and physical filing systems.
Investment Coordinator
Mackenzie Financial Corporation
1999.01 - 2001.07
- Completed paperwork, recognizing discrepancies and promptly addressing for resolution.
- Developed strong relationships with clients, addressing inquiries and resolving issues promptly for enhanced satisfaction levels.
- Improved data integrity by diligently maintaining investment records and updating systems as needed.
- review and update client accounts.
- Worked daily with Wall Street to analyze, process and implement conversions on client accounts.
- Prepared bank deposits by verifying and balancing receipts.
- Reconciled and recorded receipts, incoming cash, and other fiscal transactions.
Education
Certificate of Completion - Billing And Coding
South Tech Educational Center
Boynton Beach, FL2008
Certificate of Completion - Executive Assistant And Computer Coding
South Technical Education Center
Boynton Beach, FLAccounting And Business Management
Palm Beach Community College
Lake Worth, FLHigh School Diploma -
Atlantic High School
Delray Beach, FLSkills
- Onboarding and Orientation
- Performance Tracking and Evaluation
- Managing Operations and Efficiency
- Work Planning and Prioritization
- Teamwork and Collaboration
- Corporate Communications
- Business Analysis and Reporting
- Staff Management
- Operations Management
- Problem Resolution
- Staff Development
- Strategic Planning
- Customer Relationship Management
Timeline
Senior Manager, Insurance Services Department
MDVIP, Inc.
2011.08 - 2021.03
Administrator, Insurance and Billing Department
Simplex Healthcare
2008.06 - 2011.06
Office Manager
Liberty Landscape Lighting, LLC
2001.09 - 2008.04
Investment Coordinator
Mackenzie Financial Corporation
1999.01 - 2001.07
Certificate of Completion - Billing And Coding
South Tech Educational Center
Certificate of Completion - Executive Assistant And Computer Coding
South Technical Education Center
Accounting And Business Management
Palm Beach Community College
High School Diploma -
Atlantic High School
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