ROCHELLE LEMOINE

• Review an Analyze AR to meet Accounts Receivable metrics
• Read, Interpret , Analyze AR Reports
• Identify and correct errors with revenue and cash posting
• Payment Posting, Charge Entry
• Submitted claims to insurance companies and researched and resolved denials and explanations of benefit rejections.
• Submitted Appeals/Corrected Claims
• Identify and correct payor setups
• Insurance verification.
• Worked with team members and leadership to identify and develop process improvements.

Meet demands of busy collections group by performing high volume daily calls

Reviewed accounts to determine payment plan compliance.

Oversaw daily collections and accounts receivable activities, developing strategies to maximize collections and reduce aged accounts.

Sent incomplete or incorrect claims to managers for proper adjudication.

Corrected, completed and processed claims for payer codes.

Completed and submitted appeals for denied claims.

Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.

Identified discrepancies and carrier issues regarding billing and reimbursements.

Identified discrepancies and carrier issues regarding billing and reimbursements.

Enter patient charges and payments into electronic health records.
Processed invoice payments and recorded information in account database

Identify errors and re-filed denied or rejected claims quickly to prevent payment delays.

Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.

Completed appeals and filed and submitted claims.

Oversee all aspects of billing department to ensure correct procedures and policies are executed and maintained

Managed 22 staff members.

Human Resource Management, Payroll and supply ordering

Hire, develope and maintain a competent, productive and quality conscious workforce while maintaining competencies

Manage staff relations, including performance management, staff satisfaction and conflict management.

Create and implement staff incentive programs to improve performance

Works closely with marketing business relations management to create, improve and implement new clinic procedures to increase productivity, performance an improve patient experience.

Set up new accounts for companies/employers in regards to pre-employment physicals, drug screens and workers comp needs.

Liaison for employer/company accounts to ensure execution of protocols.

Billing Manager

Managed four person billing team

Interviewed, hired and maintained revenue producing staff

Maintained up to date knowledge of CA Worker's Comp rules and regulations

Oversaw ICD-9 to ICD-10 transition

Oversaw 2014 DC OMFS to RBRVS per DWC

Month end closing reports

AR/Collections/Appeals

ICD-9, ICD10, CPT coding, payment posting, charge entry

Employer account billing

Assistant Clinic Operations Manager from 2014-2016 performing all duties of clinic operations manager in their absence

Payment Posting, Charge Entry

AR, collections, Appeals

ICD-9-ICD-10 coding, CPT coding

Prime Clinical/Galen EMR Systems

Indepth Knowledge of CA Worker's Comp

Indepth Knowledge of Health Insurance HMO, PPO, Medicare

ICD9/CPT coding, Medicare billing, Worker's Compensation billing/authorizations. SNF billing, electronic bill submission, charge entry, payment posting, deposits, AR/Collections, patient statements. Front office duties as needed

Interviewed patients to collect medical information and insurance details. Managed physician calendar, including scheduling patient appointments and procedures. Managed front office activities, including customer service, patient appointment management, billing and collections, and office administration. ICD9/CPT coding, charge entry, payment posting, deposits, AR, Collection, Medicare, Workers Comp, PPO billing

Performed insurance verification, pre-certification and pre-authorization. Collected, posted and managed patient account payments. ICD/CPT coding, charge entry, payment posting, AR/Collections. Medicare, Worker's Comp, PPO, HMO billing. Effectively coordinated all communications between patients, billing personnel and insurance carriers.