Lori Puglisi
Washington,DC
Summary
For the past twelve years, I consciously decided to stay at home and dedicate myself to my two sons. It was a choice I made with love and devotion, fully understanding the sacrifices and rewards that would come with it. During this time, I prioritized the well-being and upbringing of my children, providing them with the love, care, and attention they deserved. I embraced the caregiver, teacher, and nurturer role, creating a warm and loving environment where they could thrive. It was a period of personal growth, learning to balance multiple responsibilities and developing invaluable skills such as patience, organization, and multitasking.
Now that my children have grown older and more independent, I am excited to embark on this new chapter in my life.
Overview
34
34
years of professional experience
Work History
Lead Teacher/Substitute Teacher
Chevy Chase Children's Center
Washington
08.2019 - 08.2023
- Provided a nurturing and stimulating environment for young children, fostering their early education and development
- Responsible for designing and implementing age-appropriate lesson plans that focused on various areas of child development, including social, emotional, cognitive, and physical skills
- Led a classroom of 16 students as the Lead Teacher, providing daily instruction and support in various areas
- Collaborated with other teachers and staff to ensure effective communication and a cohesive learning environment
- Successfully managed classroom behavior and discipline, creating a positive and respectful atmosphere conducive to learning
- Served as a reliable and dedicated Substitute Teacher across multiple grade levels, seamlessly adapting to different teaching styles and curricula.
Real Estate Agent
WC & AN Miller
Washington, DC
05.2002 - 10.2007
- Licensed in DC, Maryland, and Virginia
- Worked at one of the most reputable and well-established real estate firms in the DC metro area
- Educated buyers and sellers on all aspects of the housing market and property sales process
- Gained a strong foundation in sales and customer relations in a fast-paced environment
- Helped clients make informed decisions about buying, selling, and renting real estate
- Maintained productive communication with buyers, sellers, colleagues, attorneys, and mortgage officers throughout the home buying process
- Built and maintained strong client relationships.
Medical Billing Specialist
Drs. Mayle, London and Einbinder Neurology
Bethesda, MD
10.1997 - 09.2000
- Handled all aspects of insurance billing and claims for all doctors
- Knowledgeable in medical coding and insurance billing guidelines
- Interacted with insurance companies, healthcare providers, and patients
- Maintained compliance with all relevant regulations, including HIPAA
- Resolved claims denials and ensured timely payments.
- Conducted research on insurance policies, procedures, and regulations to ensure compliance with all applicable laws.
- Analyzed rejected claims and corrected errors as necessary before resubmitting them for payment.
- Performed quality assurance audits on submitted claims ensuring that they met industry standards.
- Adhered to HIPAA regulations when handling confidential patient information.
- Verified the accuracy of claim data prior to submission to insurance carriers.
- Maintained detailed records of all billing activities including denials, adjustments, and payments received.
Claims Eligilbility Specialist
Continental General Insurance
Omaha, NE
07.1989 - 05.1997
- Investigates and maintains simple complexity claims, including but not limited to:
- Reviewed and evaluates coverage and / or liability.
- Analyzed necessary information (i.e., reports, policies, appraisals, releases, statements, records, or other documents) to determine eligibility claim decisions.
- Established appropriate Plan of Care according to Claim Handling Guidelines
- Accurately documented claim record with eligibility details.
- Conveyed claim details (coverage, decisions, expectations, etc.) to all appropriate parties, maintaining a professional demeanor in all situations.
- Ensured claims handling is conducted in compliance with applicable statues, regulations, and other legal requirements, and that all applicable company procedures and policies are followed.
- Evaluated and process claims in compliance with industry regulations and company policies
- Collaborated with insurance providers and healthcare facilities to verify accuracy of information and resolve any discrepancies
- Conducted thorough reviews of member eligibility and benefits to determine coverage for claims submitted
Education
Licenced Real Estate Agent in DC, MD And Virginia
Greater Capital Area Association of Realtors
Rockville, MD05-2002
Certified Pastry Chef (CPC)
L'Academie De Cuisine
Gaithersburg, MD04-2001
High School Diploma -
Bryan High School
Omaha, NE06-1989
Skills
- Contract Preparation
- Client management
- Contract Negotiation
- HIPAA Compliance
- Insurance Verification
- Billing and Collection Procedures
- Invoice Coding
- Insurance Claims
- Medical record security
- ICD-10 Coding
- Data Entry
- Recordkeeping and data input
- Microsoft Office
- Benefits Administration
- Medical Billing
- Medical Coding
- Medical Terminology
- Insurance Claim Forms Review
- Insurance plan verification
- Insurance Coverage Verification
- 10-Key Touch
- Policy Interpretation
Timeline
Lead Teacher/Substitute Teacher
Chevy Chase Children's Center
08.2019 - 08.2023
Real Estate Agent
WC & AN Miller
05.2002 - 10.2007
Medical Billing Specialist
Drs. Mayle, London and Einbinder Neurology
10.1997 - 09.2000
Claims Eligilbility Specialist
Continental General Insurance
07.1989 - 05.1997
Licenced Real Estate Agent in DC, MD And Virginia
Greater Capital Area Association of Realtors
Certified Pastry Chef (CPC)
L'Academie De Cuisine
High School Diploma -
Bryan High School