LISA HARRIS
Fort Worth,TX
Summary
Highly adaptable and motivated professional with strong communication and teamwork skills. Brings a fresh perspective and unwavering commitment to quality and success. Known for proactive approach, positive attitude, and dedication to continuous learning and growth. Thrives in new environments and excels at quickly adapting to change.
Overview
28
28
years of professional experience
Work History
Data Forensic Auditor
Southwestern Health Resources
2019.03 - Current
- Provide detailed documentation on audit findings, facilitating swift corrective action when necessary.
- Maintain confidentiality, handling sensitive information discreetly throughout all stages of the audit process.
- Ensure compliance with regulatory requirements by performing regular audits and staying up-to-date on industry standards.
- Followed established auditing processes to meet internal and regulatory requirements.
- Collaborate with cross-functional teams to identify areas of risk and implement preventative measures.
- Managed approximately 15 incoming emails and reports from external customers.
Compliance Claim Auditor
North Texas Specialty Physicians-Care N Care
2017.01 - 2019.03
- Reviewed claims across multiple claim types and workflows to determine if claims are appropriately paid in accordance with benefits, contracts, and edits, which include review of specific coding and billing guidelines
- Maintained confidentiality, handling sensitive information discreetly throughout all stages of the audit process.
- Provided detailed documentation on audit findings, facilitating swift corrective action when necessary.
- Ensured compliance with regulatory requirements by performing regular audits and staying up-to-date on industry standards.
- Audited approximately 150 claims per day while managing incoming emails from external customers.
- Followed established auditing processes to meet internal and regulatory requirements.
Clinic Staff Assistant
UT Southwestern
2016.12 - 2017.01
- Managed approximately 40 patients, while maintaining incoming calls, emails, and faxes per day.
- Supported daily operations with efficient task management, contributing to overall office productivity and organization.
- Established strong working relationships with coworkers through excellent communication skills which led to improved teamwork capabilities.
- Provided clerical support, addressing routine, and special requirements.
- Maintained professional front desk, handled incoming calls and delivered exceptional service to every guest.
Claim Examiner
North Texas Specialty Physicians-Silverback TPA
2012.04 - 2016.12
- Improved customer satisfaction by providing timely and accurate claim updates throughout the process.
- Examined and processed approximately 200 claims, while managing emails from external clients.
- Developed positive relationships with clients, maintaining open lines of communication for prompt issue resolution.
- Examine/Process Medicare Claims verifying the coding and determining the deductibles, co-pays, & co-insurance payments to allow payment
- Followed Medicare guidelines to ensure claims were paid properly
- Entered alpha and numeric data from various sources
- Received inbound call from Physician's & members to resolve claim issues
Data Entry Clerk
CorVel
2010.03 - 2012.04
- Processed approximately 25 files per day, managed incoming emails, and faxes from customers.
- Followed established procedures to enter and process data correctly.
- Completed data entry tasks with accuracy and efficiency.
- Entered alpha and numeric data from various sources pertaining to inpatient medical billing
- Resolved and balanced claim payments
- Reviewed claims across multiple claim types and workflows to determine if claims were appropriately paid in accordance with benefits, contracts, and edits
Team Lead
Kaiser Permanente
1997.01 - 2009.10
- Managed day to day workflow of 35+ employees to ensure accuracy and to meet service goals
- Promoted a positive work environment by fostering teamwork, open communication, and employee recognition initiatives.
- Enhanced overall team performance by providing regular coaching, feedback, and skill development opportunities.
- Coached team members in techniques necessary to complete job tasks.
Education
GED -
70001 Learning Center
Fort Worth, Texas01.1990
Skills
- FACETS
- EXCEL proficient
- Microsoft Word proficient
- Medicare Claim Examiner
- Medical Claim Examiner
- Medicare Claim Auditor
- Meticulous attention to detail
- Strong problem solver
- Strong interpersonal skills
- Data Entry
- Customer Service
- EPIC
- PowerPoint proficient
- Detail Oriented
Reading, Cooking, Mentoring, Coaching
I am a Spiritual Life Coach for Pretty Little Life Coaching. I love helping others and offering encouragement in love. Trying new foods and cooking new dishes with my granddaughter is a wonderful way to spend time together and bond. I enjoy reading Christian Fiction and Self help books to relax.
Timeline
Data Forensic Auditor
Southwestern Health Resources
2019.03 - Current
Compliance Claim Auditor
North Texas Specialty Physicians-Care N Care
2017.01 - 2019.03
Clinic Staff Assistant
UT Southwestern
2016.12 - 2017.01
Claim Examiner
North Texas Specialty Physicians-Silverback TPA
2012.04 - 2016.12
Data Entry Clerk
CorVel
2010.03 - 2012.04
Team Lead
Kaiser Permanente
1997.01 - 2009.10
GED -
70001 Learning Center
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