Summary
Overview
Work History
Education
Skills
Interests
Timeline
Generic

Lori Motley

Tulsa

Summary

Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

Overview

11
11
years of professional experience

Work History

Credentialing Specialist

Community Care Inc.
04.2024 - Current
  • Checked in initial and re-appointment provider applications to begin the primary source verification process.
  • Verified educational backgrounds, training, licensure, and certifications of professionals to maintain standard of healthcare service delivery.
  • Conducted thorough reviews of work experience and professional history to uphold the integrity of the healthcare provider network.
  • Collaborated with healthcare provider credentialing specialists to request any additional information that's required for the initial and re-appointment application credentialing process.
  • Utilized credentialing software and databases to track the status of applications and to ensure timely processing.
  • Assisted in the development and implementation of credentialing polices and procedures to enhance efficiency and quality of service.

Client Financial Management Specialist

Burrell Behavioral Health Center
07.2019 - 03.2024
  • Facilitating the application process for clients seeking coverage through Missouri's MoHealthNet Medicaid and disability programs by offering guidance and administrative assistance.
  • Liaison between Department of Missouri Department of Mental Health and Medicaid programs, clients and clients case managers to ensure all requested information has been received to qualify for medicaid coverage for clients services rendered.
  • Patient accounts and collections.
  • Billing and follow up of insurance claims.

Patient Financial Services Representative

Cox Health Systems
06.2017 - 06.2019
  • Timely follow up for billing and collections.
  • Reviewed and handled denials and appeals.
  • Requested and reviewed patient medical records to submit with workers compensation UB and HCFA claims to work comp insurance companies.
  • Monitored all open claims daily for any change in status.
  • Managed any work comp settlements to resolve open claims.
  • Managed denied claims and prepared all documents to send to our secondary business office law firm to collect unpaid denied claims.
  • Managed electronic health records system while abiding with all HIPPA and company polices.

Patient Accounts and Collections Specialist

Dr Gil's Immediate Care
10.2014 - 06.2017
  • Registered and rescheduled patients for work comp injury and DOT collection encounters.
  • Patient account collections and billing.
  • Cash and credit handling responsibilities.
  • Work comp claim follow up and collections.

Education

No Degree - Sociology

Southwest Baptist University
Bolivar, MO

High School Diploma -

Osceola High School
Osceola, MO
05-1984

Skills

  • Provider enrollment
  • Experience with credentialing in a healthcare setting
  • Knowledge of relevant federal and state regulations
  • Proficiency with credentialing software and databases
  • Strong organizational and time-management skills
  • Excellent attention to detail
  • Billing and collections experience
  • Excellent communication skills
  • Sales

Interests

  • Gardening
  • Hiking
  • Volunteering
  • Enjoy hobbies that combine physical activity with outdoor exploration
  • Outdoor Recreation
  • Home interior decorating


Timeline

Credentialing Specialist

Community Care Inc.
04.2024 - Current

Client Financial Management Specialist

Burrell Behavioral Health Center
07.2019 - 03.2024

Patient Financial Services Representative

Cox Health Systems
06.2017 - 06.2019

Patient Accounts and Collections Specialist

Dr Gil's Immediate Care
10.2014 - 06.2017

No Degree - Sociology

Southwest Baptist University

High School Diploma -

Osceola High School

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Lori Motley