Lysandra Abeln
Winston,OR
Summary
Detail-oriented healthcare revenue cycle and coding professional with progressive experience in medical billing, claims analysis, denial management, ICD-10 coding application, and cross-functional operational support. Proven ability to review coding accuracy, resolve claim discrepancies, monitor workflow productivity, and collaborate with billing and coding teams to improve turnaround times and compliance outcomes. Experienced working in high-volume healthcare environments requiring accuracy, analytical problem-solving, regulatory compliance, and timely chart processing.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Accounts Receivable / Billing Specialist
Vituity
Modesto, CA
01.2025 - Current
- Review and analyze claims, coding-related denials, and reimbursement discrepancies to ensure accurate claim resolution and timely processing.
- Collaborate with billing and operational teams to identify invalid coding issues and support correction workflows.
- Interpret Explanation of Benefits (EOBs), payer guidelines, and financial classifications to determine appropriate follow-up actions.
- Monitor unresolved claims and escalation trends while communicating findings and process improvement opportunities to leadership.
- Create and analyze billing and workflow reports to identify processing delays, coding trends, and operational inefficiencies.
- Remote
Claims Processing Specialist
Cambia Health Solutions
Medford, OR
12.2021 - 08.2023
- Reviewed and resolved complex non-auto-processable medical claims requiring detailed coding analysis and policy interpretation.
- Applied ICD-10 diagnostic and procedural coding standards while ensuring compliance with HCPCS guidelines and healthcare regulations.
- Investigated coding discrepancies, claim edits, and denial issues to support accurate reimbursement outcomes.
- Collaborated with internal departments to resolve coding-related claim issues and improve workflow efficiency.
- Utilized Salesforce and Facets systems to manage claim tracking, workflow prioritization, and processing updates.
- Remote
Customer Service Professional
Cambia Health Solutions
Medford, OR
06.2021 - 12.2021
- Assisted members with claim inquiries, billing questions, benefit explanations, and denial resolution support.
- Researched claim discrepancies and coordinated with internal departments to facilitate timely issue resolution.
- Operated in dynamic, high-volume environments to provide skilled assistance to more than [Number] customers each day.
Accounts Payable/Receivable Clerk
Shiekh Shoes
Corona, CA
01.2019 - 06.2020
- Processed an average of 250 high-volume invoices and reconciliations while maintaining strong accuracy and timeliness standards.
- Generated reporting data to support financial tracking and operational workflow management.
- Established and maintained relationships with vendors, facilitating the addition of 5-10 new accounts monthly.
Education
Associate of Science - Business Administration
Barstow Community College
Barstow, CAHigh School Diploma -
Ace High School
Helendale, CASkills
- ICD-10, CPT & HCPCS Coding Review
- Coding Accuracy & Compliance Monitoring
- Claims Auditing & Denial Resolution
- Revenue Cycle Management
- Billing & Coding Collaboration
- Turnaround Time (TAT/TAD) Management
- Chart Review & Workflow Coordination
- Accounts Receivable Follow-Up
- Tableau & Reporting Analysis
- HIPAA Compliance
- Healthcare Financial Classifications
- Productivity & Queue Management
- Cross-Functional Team Communication
- MEDFM
- Salesforce, Facets, Workday, Microsoft Dynamics GP
Accomplishments
- Reduced claims processing errors by 20% through workflow review and quality-focused process improvements.
- Consistently exceeded productivity and accuracy expectations in high-volume healthcare claims environments.
- Improved operational efficiency through detailed reporting analysis and issue resolution collaboration.
Certification
- HIPAA Compliance Training
- Customer Service Excellence Training
- Ongoing self-directed education in medical coding compliance, denial management, and healthcare reimbursement practices
Timeline
Accounts Receivable / Billing Specialist
Vituity
01.2025 - Current
Claims Processing Specialist
Cambia Health Solutions
12.2021 - 08.2023
Customer Service Professional
Cambia Health Solutions
06.2021 - 12.2021
Accounts Payable/Receivable Clerk
Shiekh Shoes
01.2019 - 06.2020
Associate of Science - Business Administration
Barstow Community College
High School Diploma -
Ace High School