Sherri Lawhorn
Inwood,WV
Summary
Over the past years I've gained experience in both the medical office and a hospital facility. I enjoy working in the medical field and currently working remotely. I am very efficient and reliable and always willing to learn new skills for job improvement. I have also obtained a certificate from Johns Hopkins Healthcare in patient relations while employed with their organization. I am a focused patient account specialist with several years medical billing experience and well-versed in medical terminology.. Proficient at answering requests quickly and delivering exceptional results. I feel I have gained much experience and would be an asset if given the opportunity. I am seeking to maintain a full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Rep Account Follow Up
City Of Hope
02.2023 - Current
- Enhanced patient satisfaction by promptly addressing and resolving follow-up inquiries with payors.
- Maintained accurate records, contributing to better organization and case management.
- Collaborate with team members to deliver exceptional service and meet departmental goals.
- Reduced response times by implementing an efficient follow-up system for outstanding claims.
- Streamlined communication processes for improved efficiency in medical claims follow up.
- Ensured timely responses to patient queries with effective prioritization of tasks.
- Exhibited high energy and professionalism when speaking with patients and payors.
- Increased efficiency and team productivity by promoting operational best practices.
- Created and maintained detailed information regarding claims submission and follow up.
- Perform account management and analysis, as well as complete, timely and accurate follow up on the physician account balance with the objective of optimizing reimbursement and ensuring that patients receive the best City of Hope has to offer in account management.
Medical Billing/Insurance Follow up (Sub Contract)
Evoke Medical Care
06.2021 - 01.2023
- Work all rejections and denials with all commercial insurance companies and third party regarding claims and make daily calls to insurance companies regarding payment. Run all credit card payments and post to patient accounts. Follow up and make sure claims are filed correct to the proper insurance companies. Take all incoming calls from patients regarding account questions regarding statements.
- Utilized Kareo to manage and confirm patient data, such as insurance, demographic and medical history information.
- Communicated effectively with staff, patients and insurance companies by email and telephone.
- Used correct diagnosis-related groups based on patient encounter details.
- Input data into computer programs and filing systems.
- Followed exact procedures for handling transfers and other releases of medical records.
- Maintained accuracy, completeness and security for medical records and health information.
- Maintained database for storage and retrieval of medical records
- Devised workaround solutions for collections with patient related issues.
Collector MVA/Patient Representative
RSource
02.2018 - 06.2021
- Identify and resolve accounts with multiple payers involved in mva accidents. Working new and high priority accounts including investigating the coverage of the patients for WVU hospitals Ruby Memorial, Berkeley Medical Center, Jefferson Memorial Hospital, Potomac Valley Hospital, etc. Contact insurance companies and verify the correct coverage and all information regarding such as ID#, dates of coverage, policyholder, adjuster and correct mailing address. Contacting patients and attorneys via inbound and outbound calls. Answer all incoming calls and make outbound calls when necessary. Verify information correct on all claim submission. Work all daily workqueues assigned and make sure claims billed in timely manner. Follow up on all dialer accounts to obtain the correct information. Make correct adjustments to accounts when needed.
- Prepared variety of different written communications, reports and documents.
- Collaborated with team members to achieve target results.
- Handled all incoming calls daily and made outbound calls to address customer inquiries and concerns.
- Verified any changes or data updates to patient records and checked insurance information at each appointment.
- Observed all facility rules and regulations regarding patient data to promote confidentiality and integrity.
- Followed document protocols to safeguard confidentiality of patient records.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Organized patient records and database to facilitate information storage and retrieval.
Insurance Reimbursement/Billing Specialist
Harrisonburg/Rockingham Community Service Board
10.2016 - 01.2018
- Perform highly technical functions in third-party payer transactions and accounts receivable. Primary responsibility is to process electronic claims submissions and identify and resolve unprocessed/unpaid claims. correlates payer specific knowledge with claims processing to ensure maximum reimbursement. I am the primary technical resource for third party-billing and the primary liaison for the third-party payers such as Medicaid, managed care commercial insurance, workers compensation, motor vehicle, state corrections, etc. I perform financial interviews, set fees and collect fees, assist in the collections procedures of consumer overdue accounts and handle inquiries regarding consumer accounts, outstanding balances and insurance payments, also back up other departments functions and perform other duties as assigned. I also sort and disperse all incoming mail and follow up on what is needed regarding accounts and post all payments to accounts for certain commercial insurances along with general administrative duties.
- Organized positions by factors such as salary and status to develop effective categories and operational strategies.
- Gathered information about each position and related occupation with employee interviews, field observations and industry research.
- Handled incoming calls daily to address customer inquiries and concerns.
- Collaborated with team members to achieve target results.
- Participated in continuous improvement by generating suggestions, engaging in problem-solving activities to support teamwork.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Produced reports to support smooth billing operations and internal career progression.
- Performed multifactor data and cost analyses for use in areas such as support of collective bargaining agreements.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
- Handled many calls per day to address customer inquiries and concerns.
Patient Access Representative/Collections
Sentara Rockingham Memorial Hospital
07.2011 - 10.2016
- Work all daily reminders for patient accounts with all major insurance companies, motor vehicle and workers compensation claims, contact all insurance companies regarding claims status and information, see all walk in patients with account questions, enter all insurance information and any changes to patient accounts perform insurance adjustments to accounts per EOB's, sort daily mail and scan into patient accounts as needed, create payment plans according to patient balances, make adjustments to accounts and refund or apply discounts when necessary, answer all incoming calls via patients or insurances daily, document all phone calls into patient accounts when necessary per computer system and transfer any incoming calls to the proper business office or clinical staff.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Determined patient financial needs and referred eligible patients to proper county, state or federal agencies to obtain financial assistance.
- Explained estimated cost for medical treatments and answered patient questions to promote good understanding of proposed services.
- Resolved patient financial problems with guidance from documented guidelines and procedures.
- Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations.
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Attended weekly facility meetings to discuss logistical issues and obtain updated procedural and insurance-related instructions.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
- Offered simple, clear explanations to help clients and families understand hospital policies and procedures.
- Followed document protocols to safeguard confidentiality of patient records.
Patient Registration/Patient Accounts - Referrals
Johns Hopkins Community Physicians
03.2008 - 06.2011
- Improved patient registration process by streamlining data entry and reducing wait times.
- Enhanced patient experience through friendly interactions and efficient service during registration.
- Maintained accurate patient records by diligently updating information in the hospital database system.
- Collaborated with medical staff to ensure timely and accurate communication of patient information for optimal care delivery.
- Reduced errors in insurance billing by carefully verifying insurance details during patient registration.
- Ensured compliance with HIPAA regulations by safeguarding sensitive patient information during the registration process.
- Assisted with scheduling appointments, leading to improved clinic flow and reduced wait times for patients.
- Coordinated with various departments to facilitate seamless transfer of patients between units or clinics as needed.
- Streamlined documentation procedures, resulting in increased accuracy and efficiency within the department.
- Supported administrative tasks such as filing paperwork, answering phones, and maintaining office supplies inventory for smooth department operations.
- Verified insurance coverage to confirm patient coverage for necessary medical services.
- Set up patients in system by documenting key data, confirming eligibility, and verifying insurance benefits.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Gathered demographic and insurance information to register patients for medical appointments.
- Scheduled 35+ daily appointments using computerized calendars.
- Resolved scheduling conflicts to avoid double-booked appointments and provider availability issues.
Education
High School Diploma -
Midland Trail High School
Hico, West Virginia05.1987
Medical Business
National Institute of Technology
Cross Lanes, West Virginia 2006
Skills
- Filing and Data archiving
- Medical Billing
- HIPAA Compliance
- Patient Scheduling
- Excellent Communication Skills
- Professional Phone Etiquette
- Collections Processing
- CMS-1500 Billing Forms
- Insurance Eligibility
- ICD-9/ ICD-10 and CPT experience
- Working well under pressure
- Multi Line phone proficiency
- Virginia Notary Public
- Verbal and Written Communication
- Data Entry
- Medical History Recording
- Insurance Billing
- Information Sourcing
- Medical Billing Processing
- Problem Solving
- Clerical Functions
- Patient Medical Records Maintenance
- Epic Systems
- EMR Systems
- Medical Information Computerization
- Protected Health Information
- Past Due Account Management
- Demographics Information
- Medical Terminology
- Electronic Filing System Organization
- Subcontractor supervision
Certification
Patient Relations, Johns Hopkins Health System
Medical Business, National Institute of Technology
References
Reference upon request
Timeline
Rep Account Follow Up
City Of Hope
02.2023 - Current
Medical Billing/Insurance Follow up (Sub Contract)
Evoke Medical Care
06.2021 - 01.2023
Collector MVA/Patient Representative
RSource
02.2018 - 06.2021
Insurance Reimbursement/Billing Specialist
Harrisonburg/Rockingham Community Service Board
10.2016 - 01.2018
Patient Access Representative/Collections
Sentara Rockingham Memorial Hospital
07.2011 - 10.2016
Patient Registration/Patient Accounts - Referrals
Johns Hopkins Community Physicians
03.2008 - 06.2011
Patient Relations, Johns Hopkins Health System
Medical Business, National Institute of Technology
High School Diploma -
Midland Trail High School
Medical Business
National Institute of Technology
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