Lori Jones
Livingston,TX
Summary
Detail-oriented and methodical Billing Specialist offering 35+ years of experience in related roles. Exceptional abilities in conducting research, problem-solving and prioritizing simultaneous tasks. Leverages resourcefulness, critical thinking skills and superior work ethic for top job performance.
Overview
15
15
years of professional experience
Work History
Billing Specialist - Hygiene Department Lead
Dion Health
06.2023 - 09.2024
- Identified, researched, and resolved billing variances to maintain system accuracy and currency for seven (7) locations,
- Assisted colleagues in resolving complex billing issues, promoting teamwork and knowledge sharing within the department,
- Wrote appeals,
- Worked hygiene recall and scheduling for seven (7) locations,
- Lead hygiene weekly meetings for managers,
- Worked with Marketing to promote new growth in the offices.
Appeals Coordinator
Evolent Health
04.2022 - 06.2023
- Managed approximately 25 incoming calls from provider, member, and health plans with issues/concerns/complaints per day, split 100-150 incoming appeal faxes to correct queues daily,
- Started appeals and expedited appeals via phone calls from provider, member, and health plan,
- Worked Physician Appeal Requested Review (PARR) accounts,
- Worked appeals, overturns, and triage queues for delegated health plans (Commercial, Medicare, and Medicaid).
Appeals Coordinator
PHI Air Medical
11.2018 - 07.2021
- Researched insurance companies' rules and regulations, researched State and Federal Medicaid and Medicare rules and regulations, appeal denials on behalf of patient and PHI with written communications, advocated for PHI and patients at Administrative Law Judge (ALJ) hearings. Wrote a minimum of six (6) Medicare and Medicaid appeals per day.
Medical Administration Assistant
Cigna Medical Group
09.2016 - 11.2018
- Scheduled appointments and registered approximately 30 patients per day using EPIC, EHR, and RIS,
- Verified appointment times with patients,
- Managed a multi-lined phone system,
- Maintained strict patient and physician confidentiality,
- Verified insurance,
- Greeted and arrived patients for Radiology, Lab, and General Surgery,
- Balanced daily accounts receivable.
Patient Services Coordinator
Dr. Robert Brei
02.2014 - 05.2016
- HIPAA Compliance Officer,
- Scheduled appointments approximately 10 appointments per day,
- Registered patients,
- Verified appointment times with patients,
- Assisted in the maintenance of electronic dental records,
- Managed a multi-lined phone system,
- Balanced the daily receipts.
Front Office Team Lead/ Patient Service Specialist IV
University of Arizona Health Network (UAHN)
07.2009 - 10.2013
- Team lead for six (6) individuals,
- Scheduled approximately 20 appointments daily,
- Registered patients,
- Verified appointment times with patients,
- Assisted in the maintenance of medical charts and/or electronic medical records,
- Managed a multi-line phone system,
- Verified patients' eligibility and claims status with insurance agencies,
- Researched questions and concerns from providers,
- Submitted electronic/paper claims documentation for timely filing,
- Maintained and updated collections tracking spreadsheet.
Education
Master of Health Administration -
University of Phoenix
Phoenix, AZ09.2021
Bachelor of Science in Health Administration -
University of Phoenix
Phoenix, AZ11.2017
Skills
- Team Lead
- Patient Care
- Communication
- Excellent Problem Solver
- Planning Ability
- Resourceful and Reliable Worker
- Composed and Professional Demeanor
- Office Management Professional
Timeline
Billing Specialist - Hygiene Department Lead
Dion Health
06.2023 - 09.2024
Appeals Coordinator
Evolent Health
04.2022 - 06.2023
Appeals Coordinator
PHI Air Medical
11.2018 - 07.2021
Medical Administration Assistant
Cigna Medical Group
09.2016 - 11.2018
Patient Services Coordinator
Dr. Robert Brei
02.2014 - 05.2016
Front Office Team Lead/ Patient Service Specialist IV
University of Arizona Health Network (UAHN)
07.2009 - 10.2013
Master of Health Administration -
University of Phoenix
Bachelor of Science in Health Administration -
University of Phoenix
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