Lynn Simms
Medical Biller/Coder
Saint Charles,Missouri
Summary
Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts and reviewing health records to identify proper diagnosis codes for billing. Offers background in reviewing, analyzing and managing medical record information to obtain prior authorizations from insurance companies and ensure payment.
Overview
16
16
years of professional experience
7
7
years of post-secondary education
3
3
Certifications
Work History
Director/Certified Manager
Covenant In-home Care
Saint Peters, Missouri
09.2008 - 05.2020
- Maximized performance by monitoring daily activities and mentoring team members.
- Recruited, trained, and hired top performers to add talent and value to all department.
- Controlled costs and optimized spending via restructuring of budgets for labor, capital assets, inventory purchasing and technology upgrades.
- Expanded cross-functional organizational capacity by collaborating across departments on priorities, functions and common goals.
- Set up and maintained new medicaid electronic billing system
- Prepared billing statements for patients and verified correct diagnostic coding: ICD-9/ICD-10.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Participated in workshops and other training opportunities to remain current on billing procedures, regulations and industry updates.
- Complied with HIPAA privacy and security regulations to protect patients' medical records and information.
- Oversaw billing for Medicaid PCA, waiver and skilled claims, commercial insurance and private pay clients.
- Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
Director of Operations/Certified Manager
Mercy Visions Home Health
Saint Charles, United States
08.2011 - 03.2016
- Oversaw day-to-day production activities in accordance with business objectives.
- Defined, implemented and revised operational policies and guidelines.
- Worked collaboratively with functional leaders to implement new procedures and corrective actions to improve quality.
- Achieved team goals through formalized training plans, coaching and performance management.
- Scheduled employees for shifts, taking into account customer traffic and employee strengths.
- Negotiated price and service with customers and vendors to decrease expenses and increase profit.
- Trained and hired new employees on proper protocols and customer service standards.
- Tracked employee attendance and punctuality, addressing repeat problems quickly to prevent long-term habits.
- Generated and developed leads, using networking and in-house marketing system to acquire new clients.
- Developed and updated policies and procedures, maintaining compliance with statutory, regulatory and local, state and federal guidelines relating to HIPAA, benefits administration and general liability.
- Created customized care plans, working with hospital staff and families to assess and meet individual needs.
- Reviewed patient records, identified medical codes and created invoices for billing purposes.
- Orchestrated medical coding, payment posting, accounts receivables and collections.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Filed and updated patient information and medical records.
- Communicated with insurance providers to resolve denied claims and resubmitted.
Education
BBA - Business Administration And Management
Tennessee State University
Nashville, TN 08.1996 - 06.2001
Associate Degree in Nursing - Nursing
St Charles Community College
City Of Saint Peters, MO 01.2020 - Current
Skills
Policies and procedures
Certification
Certified Manager, DHSS- 2008-present
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
There is a powerful driving force inside every human being that, once unleashed, can make any vision, dream, or desire a reality.
Tony Robbins
Timeline
CNP - Certified Notary Public-2021-present
01-2021
Associate Degree in Nursing - Nursing
St Charles Community College
01.2020 - Current
CNA - Certified Nursing Assistant
04-2012
Director of Operations/Certified Manager
Mercy Visions Home Health
08.2011 - 03.2016
Director/Certified Manager
Covenant In-home Care
09.2008 - 05.2020
Certified Manager, DHSS- 2008-present
08-2008
BBA - Business Administration And Management
Tennessee State University
08.1996 - 06.2001
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