Lisa McEnery
WHITING,IN
Summary
Smart Medical Biller successful at resolving disputes and billing inquiries. Brings organized, professional presentation skills, adherance to strict data confidentiality and HIPAA requirements. Detail-oriented approach, cultivated over more than 20 years, toward performing intricate billing procedures with undeniable level of detail.
Overview
23
23
years of professional experience
Work History
Medical Billing Specialist
Benchik Medical Center
Whiting, IN
08.2021 - Current
- Developed and maintained a comprehensive billing system database for accurate record-keeping and reporting.
- Streamlined billing processes through the introduction of automated systems, reducing manual errors.
- Established clear billing policies and procedures, ensuring consistent application across all client accounts.
- Reviewed appeals processes and assisted in preparing appeal letters when necessary.
- Conducted insurance verification and pre-authorization, coded medical procedures and managed patient charts.
- Prepared detailed financial statements related to billing for executive review and decision-making.
- Managed billing calendar and scheduled claims for payments.
- Monitored accounts receivable aging reports and worked proactively to reduce outstanding balances due from patients or insurers.
- Conducted regular audits of billing activities to ensure compliance with company policies and regulatory standards.
- Coordinated preparation of external audit materials and external financial reporting.
- Conducted audits on claims submitted by medical billing staff, ensuring compliance with all applicable laws and regulations.
- Resolved issues related to denied or rejected payments from insurance companies.
- Assisted in developing policies and procedures related to medical billing operations.
- Resolved billing issues by applying knowledge and completing in-depth research.
- Oversaw daily activities related to the processing of electronic claims submissions.
- Worked closely with clinical staff to ensure timely submission of claims and accurate coding practices.
Medical Billing Specialist
Kurani Med Inc
Hammond , IN
01.2016 - 12.2020
- Reviewed and verified benefits and eligibility with speed and precision.
- Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
- Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.
- Remained up-to-date with all insurance requirements, including details of patient financial responsibilities, fee-for-service and managed care plans by participating in training programs.
- Determined prior authorizations for medication and outpatient procedures.
- Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Analyzed and interpreted patient medical and surgical records to determine billable services.
- Prepared billing statements for patients, ensuring correct diagnostic coding.
- Posted and adjusted payments from insurance companies.
- Completed appeals and filed and submitted claims.
- Maintained timely and accurate charge submission through electronic charge capture, including billing and account receivables (BAR) system and clearing house.
- Applied payments, adjustments and denials into medical manager system.
Medical Billing Specialist
Dr Mahendra Patel
Hammond , IN
09.2001 - 12.2015
- Reviewed and verified benefits and eligibility with speed and precision.
- Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
- Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.
- Remained up-to-date with all insurance requirements, including details of patient financial responsibilities, fee-for-service and managed care plans by participating in training programs.
- Determined prior authorizations for medication and outpatient procedures.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Analyzed and interpreted patient medical and surgical records to determine billable services.
- Meticulously tracked and resolved underpayments.
- Posted and adjusted payments from insurance companies.
- Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
- Completed appeals and filed and submitted claims.
- Maintained timely and accurate charge submission through electronic charge capture, including billing and account receivables (BAR) system and clearing house.
- Precisely completed appropriate paperwork and system entry regarding claims.
- Performed quality control of data entry system to verify proper posting of claims and payments.
- Applied payments, adjustments and denials into medical manager system.
- Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
- Posted charges, payments and adjustments.
Education
Bachelor of Science - Accounting
Purdue University Calumet
Hammond, IN05.2005
Skills
- Epic, Lytec, Medisoft, CollaborateMD & Practice Fusion software applications proficiency
- Generally Accepted Accounting Principles (GAAP)
- ACO Compliance
- HIPAA compliance
- Files and records management
- Quality-oriented team player
- Bill payment
- Claim review
- Billing codes
- ICD-10 coding & proficiency
- Claim submission
- Medical coding understanding
- Insurance collections
- Recordkeeping
- Outpatient prior authorizations
- Medication prior authorizations
References
References available upon request.
Timeline
Medical Billing Specialist
Benchik Medical Center
08.2021 - Current
Medical Billing Specialist
Kurani Med Inc
01.2016 - 12.2020
Medical Billing Specialist
Dr Mahendra Patel
09.2001 - 12.2015
Bachelor of Science - Accounting
Purdue University Calumet
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