Lisa Herron

• Used judgment and initiative in handling confidential matters and requests.
• Coded and entered daily invoices with in-house accounting software.
• Reviewed patient insurance information to ensure accuracy and completeness of claims submission.
• Verified medical codes for diagnosis, treatments, procedures and supplies using ICD-10 coding system.
• Compiled and processed data for billing purposes utilizing billing software programs.
• Communicated with insurance representatives to complete claims processing or resolve problem claims.
• Reviewed account information to confirm patient and insurance information is accurate and complete.
• Applied HIPAA privacy and security regulations while handling patient information.
• Submitted appeals using provider portals and phone communication.
• Handled billing, waivers and claims for private and commercial clients.
• Accurately input procedure codes, diagnosis codes and patient information into billing software to generate up-to-date invoices.

• Reviewed patient medical records to determine medical necessity for requested services and procedures.
• Verified insurance eligibility, coverage levels, and benefit parameters prior to submission of precertification requests.
• Compiled and submitted precertification requests for review by payers in accordance with established timelines.
• Provided follow-up on pending precertification requests to ensure timely processing.
• Identified opportunities for improvement within the precertification process and recommended solutions accordingly.
• Processed appeals when necessary following denial or rejection of claims due to lack of proper authorization.
• Attended meetings with providers regarding their utilization management needs.
• Ensured compliance with all HIPAA regulations pertaining to protected health information.
• Explained eligibility details and affordability options to patients with kindness and respect.
• Explained reasons behind application denials and recommended further action.
• Participated in new hire training and development tasks.
• Transmitted medical records and other correspondence by mail, e-mail, or fax.
• Managed front office customer service, appointment management, billing and administration tasks to streamline workflow.
• Interviewed patients to complete case histories and intake forms.
• Scheduled tests, lab work or x-rays for patients based on physician orders.
• Arranged hospital admissions for patients as required.
• Transcribed recorded practitioners' diagnoses and recommendations into medical records.
• Scheduled and confirmed patient appointments and consultations.
• Communicated with patients with compassion while keeping medical information private.
• Prepared reports, invoices, letters, or medical records using word processing, spreadsheet, or other software applications.
• Compiled and coded patient information or data in appropriate computer system.
• Ordered and maintained supply inventory for medical office.
• Assisted physicians with finalizing reports, speeches or presentations.

Obtained free medication for patients through pharmaceutical companies as well as any type of assistance they may need: housing, food, clothing, utilities, financial, mental health.

Assist in the clinic as needed, lab, pharmacy, patient vitals, injections, assist physicians with minor office procedures, scheduling. Answer multi line phone system, fax, computer. Chart documentation.

Meet with patient's, obtaining all medical history, explaining procedure and process for spinal cord stimulator trial and eventually permanent placement. Submit authorization requests to insurance companies, participating in peer to peer discussions for approvals, denials and appeals.

Assist in clinic as needed. Rooming patients, vitals, chart documentation.