Lucy Schultz
Saginaw,MI
Summary
Organized professional knowledgeable in regulatory standards and compliance requirements. Confident Medical Billing and Coding as well as Prior Authorization Specialist with a background spent working in, effective orally and written communication and developing prior authorization, billing, coding, resolution of denials and accounts receivable management.
Overview
11
11
years of professional experience
Work History
Prior Authorization Specialist
CMU Health
Saginaw, MI
04.2014 - Current
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
- Tracked referral submission during facilitation of prior authorization issuance.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Verified eligibility and compliance with authorization requirements for service providers.
Billing Representative
MidMichigan Home Care
Midland, MI
02.2013 - 02.2014
- Reviewed and solved account and billing discrepancies.
- Assessed accounts for payment status and reached out to customers.
- Received incoming information and entered into database system.
- Coordinated with intermediate parties to obtain payments and resolve issues.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
Instructor, Lead Billing & Administration
Dorsey Schools
Saginaw, MI
03.2011 - 02.2013
- Used learning assessments to regularly monitor student understanding of class concepts and materials.
- Decreased learning time by initiating new learning methods and ensuring complete student comprehension.
- Emphasized safe working and classroom conditions and practices.
- Optimized learning plans, quantifying student progress through test administration.
- Created guides and course materials to reiterate lecture information and help students.
Education
BBA - Business Management
Northwood University
Midland, MI01.2008
Associate of Arts - Business Administration And Management
Delta College
University Center, MI01.2006
Skills
- Healthcare Terminology
- VA Community Care/Optum knowledge
- Health Insurance Plan Knowledge
- Diagnostic Codes
- Referral Tracking
- Patient Registration
- Microsoft Excel
- Federal Laws & Regulatory Codes
- Electronic Health Record Applications
- Benefits Verifications
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
Every problem is a gift—without problems we would not grow.
Tony Robbins
Timeline
Prior Authorization Specialist
CMU Health
04.2014 - Current
Billing Representative
MidMichigan Home Care
02.2013 - 02.2014
Instructor, Lead Billing & Administration
Dorsey Schools
03.2011 - 02.2013
BBA - Business Management
Northwood University
Associate of Arts - Business Administration And Management
Delta College
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