Lisa Raymond
Rossville,GA
Summary
Results-driven payment poster with expertise in payment processing, medical billing, and insurance verification. Committed to ensuring accuracy and efficiency in financial operations and client communication.
Overview
26
26
years of professional experience
Work History
Payment Poster
Galen Healthcare
Hixson, Tennessee
05.2023 - Current
- Managed incoming payments and documented transactions in financial systems.
- Coordinated with billing teams to resolve payment record discrepancies, ensuring accurate financial reporting.
- Maintained clear documentation of payment transactions for auditing purposes.
- Assisted in reconciling accounts to ensure proper financial reporting.
- Prepared reports and summaries for month-end closing activities to facilitate timely financial reconciliation.
- Posted payments and sent reviews and denials.
- Balanced daily cash postings with deposits, verifying accuracy of information entered into the system.
Precertification Specialist
Memorial Healthcare
Chattanooga, Tennessee
03.2000 - 02.2023
- Facilitated precertification processes for medical services and procedures, ensuring timely approvals and adherence to insurance guidelines.
- Reviewed medical documentation to ensure compliance with insurance requirements.
- Collaborated with healthcare providers to gather necessary patient information.
- Utilized electronic health record systems for efficient data management and retrieval.
- Communicated with patients regarding precertification status and requirements.
- Coordinated with insurance companies to resolve precertification inquiries promptly.
- Assisted in training new staff on precertification procedures and policies.
- Verified insurance eligibility, coverage levels, and benefit parameters prior to submission of precertification requests.
- Assisted with answering provider inquiries regarding preauthorization requirements and processes.
- Reviewed patient medical records to assess medical necessity, enhancing compliance with insurance requirements.
- Attended meetings with providers regarding their utilization management needs.
- Ensured compliance with all HIPAA regulations pertaining to protected health information.
- Processed appeals following denial or rejection of claims due to lack of proper authorization.
- Identified and recommended process improvements within precertification, contributing to streamlined operations and improved service delivery.
- Scheduled tests, lab work or x-rays for patients based on physician orders.
Skills
- Payment processing
- Medical billing
- Insurance verification
- Cash application
- Credit and collections
- Overpayment identification
- Electronic records management
- Cash handling
- Proficiency in [software]
- Attention to detail
- Client communication
Timeline
Payment Poster
Galen Healthcare
05.2023 - Current
Precertification Specialist
Memorial Healthcare
03.2000 - 02.2023