Sandra Lyons
Twentynine Palms,CA
Summary
Experienced professional seeking a position to utilize extensive office experience, technical training, and strong work ethic. Committed to enhancing company growth through efficiency and delivering exceptional results. Seeking an opportunity that values hard work and offers potential for professional advancement based on merit.
Overview
20
20
years of professional experience
Work History
Benefits Specialist/Payroll
Morongo Unified School District
09.2021 - Current
- Resolved issues and inquiries from plan participants regarding health and welfare benefits and deductions through telephone, email, and in-person interactions.
- Explained benefits to plan participants in easy to understand terms in order to educate each on available options.
- Assisted in resolving complex benefits issues, leading to increased employee satisfaction and retention rates.
- Educated managers on current benefit offerings and policies, enabling them to better assist their teams with questions or concerns.
- Processed employee life event changes, ensuring timely updates to benefits and coverage for qualifying events such as marriage or the birth of a child.
- Observed strict procedures to maintain data and plan participant confidentiality.
- Implemented open enrollment system to streamline benefits processes for employees.
- Performed benefits audits to identify discrepancies and opportunities for improvement in plan design or administration.
Patient Account Representative
HealthCare Solutions/Conifer Healthcare
04.2019 - Current
- Responsible for all aspects of follow up and collections, including making telephone calls and accessing payer websites
- Identify issues or trending and provide suggestions for resolution
- Accurately and thoroughly documents the pertinent collection activity performed
- Review account information and necessary systems applications to determine the next appropriate work activity
- Verify claims adjudication utilizing appropriate resources and applications
- Initiate telephone or letter contact to patients to obtain additional information as needed
- Perform appropriate billing functions, including manual re-bills as well as electronic submission to payers
- Edit claims to meet and satisfy billing compliance guidelines for electronic submission
- Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory
- Participate and attend meetings, training seminars and in-services to develop job knowledge
- Participate in the monthly, quarterly and annual performance evaluation process with their Supervisor
- Respond timely to emails and telephone messages as appropriate
- Communicate issues to management, including payer, system or escalated account issues.
Practice Manager
Andre M Kasko, D.O./ Family Health Center of Joshua Tree
07.2015 - 05.2018
- Manages day to day operations of two clinics, including personnel and staffing, scheduling, procurement of supplies and services, coding and billing, and works closely with Medical Director to streamline functioning of clinics
- Documented effectiveness decreasing outstanding billing by over $500,000.00, and balancing of outstanding accounts
- Ensures daily batching, keying and/or submission of charges
- Maintains accounting controls by preparing and recommending policies and procedures
- Guides accounting clerical staff by coordinating activities and answering questions
- Maintains confidentiality of staff, patient information and records
- Clearly documents follow up of assigned problem solving with employees and/or patients
- Management of medical records in compliance with HIPPA
- Positively deals with patient complaints
- Recruits, interviews, and selects employees, Nurse Practitioners, Physician Assistants and Physicians
- Responsible for orientation, training, supervising, evaluation, and terminating of staff
- Reviews and suggests wage increases permitted within budgetary limits
- Responsible for credentialing of all providers and verifying that all providers maintained active required licensures
- Processed and completed Cost Reporting
- Implemented and organized Physician contracts, NP Contracts and PA contracts
- Analyze business operations, trends, costs, revenue, financial commitments and obligations to project future revenues and expenses and provide advice
- Survey operations to ascertain accounting needs and to recommend, develop and maintain solutions to business and financial problems
- Assist with payroll preparation and verification of time cards completion
- Scheduled surgeries, coordinated with hospital and patient about arrival times and any preoperative information that was required i.e
- Consents and lab work
- Assisted in establishing Disability claims, and submitted supplemental information.
Emergency Department Revenue Cycle Coordinator / Insurance Collector
Hi-Desert Medical Center
08.2011 - 07.2015
- Primary function of balancing accounts, billing secondary insurances, following up on outstanding accounts, appealing accounts to insurance providers, consultation and advocacy in regards to patient balances, verify contracted rates are paid, send medical records or detailed bills as requested
- Secures outstanding balance payments for care of hospital employees by establishing payroll deductions; obtaining signatures for automatic transfers.
Physician Liaison
Hi-Desert Medical Center (on-site facility)
08.2011 - 01.2015
- Send daily logs of daily occupancy totals, assist patients in getting updated information to the company in a timely manner, process 'self-pay' accounts and verify insurance, send 'code blue' accounts as soon as available, communicate with Emergency Department physicians, communicate with the primary office should they have any questions about an insurance type.
Night Replenishment / Warehouse
CSSI, Inc. /Marine Corp Air Ground Combat Center Commissary
11.2007 - 08.2011
- Ensure accuracy of shipment with invoice, design and assemble advertising signs and displays of merchandise on shelves, counters, and tables to attract customers and promote sales
- Stock shelves, racks, cases, bins, and tables with new or transferred merchandise
- Take inventory or examine merchandise to identify items to be reordered or replenished
- Answer customers' questions about merchandise and advise customers on merchandise selection.
Medical Receptionist
The medical office of Daniel J. Fraschetti, D.O.
08.2004 - 12.2007
- Scheduled appointment, verified insurance type, verified co-payment and/or coinsurance due at time of visit
- Assigned and regulated clerical/secretarial functions and delegated work responsibilities among the office personnel
- Designed filing systems and arranged the procedures for maintaining records, maintained the office budget and secured the personnel files
- Supervise the ordering of office equipment and supplies, health and safety policies, and customer service
- Trained the newcomers regarding office procedures and policies, and managed/conducted the professional training programs for the organization’s employees
Education
General Education -
Twentynine Palms High School
Twentynine Palms, CA06.1999
Skills
- New employee enrollment
- Verbal and written communication
- Healthcare Benefits
- Benefits Explanation
- Relationship Building
- Benefits Administration
- Policy Interpretation
- Documentation And Reporting
- Special projects
- Retirement plans
- Payroll coordination
- Attention to Detail
- Records Maintenance
- Teamwork and Collaboration
- Problem-Solving
- Active Listening
- Adaptability and Flexibility
- Self Motivation
Timeline
Benefits Specialist/Payroll
Morongo Unified School District
09.2021 - Current
Patient Account Representative
HealthCare Solutions/Conifer Healthcare
04.2019 - Current
Practice Manager
Andre M Kasko, D.O./ Family Health Center of Joshua Tree
07.2015 - 05.2018
Emergency Department Revenue Cycle Coordinator / Insurance Collector
Hi-Desert Medical Center
08.2011 - 07.2015
Physician Liaison
Hi-Desert Medical Center (on-site facility)
08.2011 - 01.2015
Night Replenishment / Warehouse
CSSI, Inc. /Marine Corp Air Ground Combat Center Commissary
11.2007 - 08.2011
Medical Receptionist
The medical office of Daniel J. Fraschetti, D.O.
08.2004 - 12.2007
General Education -
Twentynine Palms High School