Leslie Strawbridge
Caruthersville,United States
Summary
Experienced Revenue Cycle and Healthcare Reimbursement Specialist with a strong track record in post pay audits, denials management, and appeals coordination. RHIT-certified with progressive experience across hospitals, academic medical centers, and third-party vendors. Skilled at leading teams, coordinating multi-state payer audit responses, and leveraging deep knowledge of payer policies and clinical documentation to maximize reimbursement. Recognized for accuracy, professionalism, and the ability to streamline processes while ensuring regulatory compliance and operational excellence. Proven ability to resolve complex claim denials, support coding and billing improvements, and collaborate across revenue cycle, case management, and clinical teams.
Overview
23
23
years of professional experience
Work History
Payment Resolution Specialist-II, Post Pay Audit Tech Team Lead (Hospital Denials & Appeals)
Trinity Healthcare
05.2023 - Current
- Coordinates follow-up activities with Utilization Review/Case. Serve as a management/Coding/Nurse Liaison to provide required clinical support, as well as to ensure timely follow-up and action for hospital pre and post pay audit appeals. Works with Patient Access and other necessary parties to resolve all accounts.
- Applies knowledge of specific payer payment rules, managed care contracts, authorization issues.
- Manage 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.
- Proactively follows up on payment delays and variances by contacting patients.
- Assist with training new incoming employees.
- Complete EPIC audit write off and contractual adjustments when in agreement with audit findings.
Post Pay Audit Coordinator (Trinity Healthcare)
Agile/Healthrise Healthcare
03.2022 - 05.2023
- Managed & maintained Post Pay Audit follow up work excel spreadsheets for multiple states. Responsible for documenting follow up findings on multiple applications & audit spreadsheets.
- Worked high dollar/aged/new accounts as necessary to ensure efficient revenue cycle recovery.
- Maintained professional relationships and communication with all payer & audit vendor types.
- Identified trending issues with all payer/audit vendors & present issues & resolution to management team.
- Assisted Post Pay Audit Team RNs with audit denials by investigating/research to find resolution.
- Team contributor helping to assist in the development of new workflow processes regarding Post Pay Audit Team follow up.
Revenue Recovery Specialist II
RSource Healthcare Receivable Management
03.2020 - 03.2022
- Managed inventory from multiple clients with a variety of accounts with complex issues. Responsible for maintaining professional relationships and communication with all payer types.
- Ensured new and priority accounts were worked within 48 hours.
- Age and high dollar accounts were worked as necessary to ensure efficient revenue cycle recovery.
- Identified and resolved any underlying complex issues causing delay to obtain timely reimbursement. Prepare and submit appeals with required and supportive documentation in a timely manner. Substantiate arguments based on medical necessity by reviewing patient medical records. Create appeals for no authorization denials.
- Demonstrated proficiency with payer web portals, client systems and databases to document and resolve all accounts. Identify payer resolution, trends and relay to management and team. Assist in training hires when needed.
Coding Appeals Specialist
Washington University School of Medicine PBS, St. Louis
St. Louis
06.2019 - 02.2020
- Investigated and conducted problem solving on reimbursement issues in collaboration other coding staff and faculty. Worked directly with physicians and other clinical staff as needed to provide documentation feedback and to develop appeals. Researched payer policies and processes. Reviewed clinical documentation in the medical record to identify all pertinent facts necessary to select the comprehensive diagnoses and procedures that fully describe the patient's conditions and treatment. Worked assigned Epic Work queues for Physical Therapy, Occupational Therapy, Speech Therapy & Neurology services, CRM tasks, and reviews remittance advices for rejection and accuracy of payment amounts as needed. Identifies invoices that have been rejected per department criteria.
- Worked with coders and IBC staff with medical terminology and policy interpretation as required.
- Managed code evaluation and management services to appropriate CPT code level.
- Ensured ICD codes are linked appropriately to services provided.
- Led charge corrections when necessary.
- Performed accounts receivable (AR) functions in the Epic billing system, including updating insurance information, demographics.
- Worked special projects as when assigned.
Patient Account Specialist II
Missouri Cancer Associates, Columbia
Columbia
03.2018 - 06.2019
- Worked weekly insurance payer denials from O drive. Review insurance payer denial reason was denied; research to find resolution to obtain payment. Managed weekly Availity Realmed insurance payer denials. Review insurance payer denial reason claim was denied; research to find resolution to obtain payment. Communicated with insurance payers by phone or email contact on a daily basis to get more detailed explanation why a claim was denied. Work with the insurance payer to see what is needed or what process needs to be taken to get a claim paid through actions of submitting additional medical documentation or submitting reconsideration/appeals through means based on medical necessity.
- Submitted all claims for Medicare & Medicaid through the proper designated web portals for processing and payment. This includes all high-cost chemo drug claims that must be submitted daily via PWK report.
- Handled incoming patient calls related to account balance, insurance payer questions regarding insurance payments, deductibles, co-insurance, co-payments and denials.
- Notified Accounts Receivable Supervisor on all trending issues affecting claims to be denied.
- Continuously promoted to work in a team atmosphere to assist co-workers in all situations.
- Delivered the highest customer care to all our patients with compassion & understanding.
Revenue Cycle Support
American Surgical Professionals, Houston
Houston
11.2017 - 02.2018
Client Support Specialist
Premier Medical Appeals, Houston
Houston
06.2016 - 09.2017
Verification Denial Specialist
Christus Healthcare System, Katy
Katy
02.2016 - 06.2016
Verification Specialist II
Parallon Business Solutions, Houston
Houston
12.2013 - 06.2015
Billing/Collections Representative
Key Access Institute, Houston
Houston
04.2013 - 08.2013
Office Administrator/Collections
Hanger Clinic, Houston
Houston
10.2012 - 03.2013
Medical Claims Analyst
Inventiv Medical Management, Augusta
Augusta
08.2007 - 08.2012
Patient Accounts Coordinator
New Hope Treatment Centers, North Charleston
North Charleston
03.2007 - 09.2007
Medical Receptionist
Southeastern Spine Institute, Mount Pleasant
Mount Pleasant
07.2006 - 03.2007
Patient Financial Representative
Roper St. Francis Home Healthcare, Charleston
Charleston
07.2004 - 07.2006
Patient Service Representative/Medical Biller
Spring Harbor Hospital, Portland
Portland
03.2003 - 03.2004
Account Specialist
Insurance Innovations, South Portland
South Portland
11.2002 - 03.2003
Education
Medical Billing & Coding Courses completed
Rasmussen College
Associate of Applied Science - Registered Health Information Technician (RHIT) Certified
Rasmussen College
Ocala, FL12.2014
Skills
- Revenue Cycle Management
- Post Pay Audits
- Denials & Appeals
- EPIC
- ICD-10-CM/PCS
- RHIT Certified
- Audit Coordination
- Healthcare Reimbursement
- Utilization Review
- Claims Resolution
- Charge Corrections
- Payer Communication
- Audit Vendor Management
- Medical Necessity Appeals
- Payment Integrity
- Documentation Review
- Hospital Billing
- Coding Support
- CPT Coding
- Microsoft Office
- Meditech
- Midas
- Optum 360 Encoder
- Availity Realmed
- Medicaid
- Medicare
- Remote Healthcare Roles
- Team Leadership
- Process Improvement
- Training & Mentoring
- Cost Containment
- EMR Systems
- Insurance Verification
- Patient Financial Services
- HIM Compliance
Timeline
Payment Resolution Specialist-II, Post Pay Audit Tech Team Lead (Hospital Denials & Appeals)
Trinity Healthcare
05.2023 - Current
Post Pay Audit Coordinator (Trinity Healthcare)
Agile/Healthrise Healthcare
03.2022 - 05.2023
Revenue Recovery Specialist II
RSource Healthcare Receivable Management
03.2020 - 03.2022
Coding Appeals Specialist
Washington University School of Medicine PBS, St. Louis
06.2019 - 02.2020
Patient Account Specialist II
Missouri Cancer Associates, Columbia
03.2018 - 06.2019
Revenue Cycle Support
American Surgical Professionals, Houston
11.2017 - 02.2018
Client Support Specialist
Premier Medical Appeals, Houston
06.2016 - 09.2017
Verification Denial Specialist
Christus Healthcare System, Katy
02.2016 - 06.2016
Verification Specialist II
Parallon Business Solutions, Houston
12.2013 - 06.2015
Billing/Collections Representative
Key Access Institute, Houston
04.2013 - 08.2013
Office Administrator/Collections
Hanger Clinic, Houston
10.2012 - 03.2013
Medical Claims Analyst
Inventiv Medical Management, Augusta
08.2007 - 08.2012
Patient Accounts Coordinator
New Hope Treatment Centers, North Charleston
03.2007 - 09.2007
Medical Receptionist
Southeastern Spine Institute, Mount Pleasant
07.2006 - 03.2007
Patient Financial Representative
Roper St. Francis Home Healthcare, Charleston
07.2004 - 07.2006
Patient Service Representative/Medical Biller
Spring Harbor Hospital, Portland
03.2003 - 03.2004
Account Specialist
Insurance Innovations, South Portland
11.2002 - 03.2003
Medical Billing & Coding Courses completed
Rasmussen College
Associate of Applied Science - Registered Health Information Technician (RHIT) Certified
Rasmussen College