Summary
Overview
Work History
Education
Skills
Recognition
Certification
Timeline
Generic
Stephanie Lyons

Stephanie Lyons

Owenton,KY

Summary

Detail oriented medical coder seeking a position where I can utilize my strong investigational and communication skills while learning various aspects of the insurance business.

Overview

18
18
years of professional experience
1
1
Certification

Work History

Team Lead - CPC

Humana Inc.
04.2024 - Current
  • I moved back to my previous position of Team Lead due to the understanding that I was not prepared for a supervisor role

Supervisor - CPC

Humana Inc.
10.2023 - 04.2024
  • In this position I am responsible for managing the stateside Code Edit Dispute team as well as managing the teams inventory
  • I have furthered my time management and organizational skills with the management of this work
  • When new hires initially start in their role, I help to run the training sessions to educate on our processes and expectations
  • I work daily with new employees and review their training assignments to help guide them on any questions or areas of improvement they need through email and meetings
  • I help to manage the daily work by creating a daily spreadsheet of issues to review
  • I additionally manage issues received from the Grievance and Appeals team sent for our offshore team to review
  • I’m in charge of ensuring associates review the issues and complete them by the due dates
  • With managing this work, I have learned to become extremely detailed with how the work is worded, structured, and the type of support needed to prevent the IRE from overturning a claim
  • I manage the email inbox for these issues as well and handle any pushback or escalations regarding the completed reviews
  • I will educate associates on any errors made with the reviews and update any processes needed to help make sure reviews are completed accurately
  • I oversee reviewing claims returned from the IRE on a weekly basis and present these issues during a cross team meeting
  • I also complete any work received from management, such as escalated issues to review and DOI complaints within the needed time frame
  • From managing multiple offshore and onshore teams I have learned to become more organized and thoughtful with how I structure my daily work and tasks
  • I have also learned better communication skills through managing the work of others and trying to maintain consistency

Team Lead - CPC

Humana Inc.
08.2021 - 10.2023
  • In this position I am responsible for multiple aspects of training and monitoring of the work for onshore and offshore associates on my team
  • I have furthered my time management and organizational skills with the management of this work
  • When new hires initially start in their role, I help to run the training sessions to educate on our processes and expectations
  • I work daily with new employees and review their training assignments to help guide them on any questions or areas of improvement they need through email and meetings
  • I help to manage the daily work by creating a daily spreadsheet of issues to review
  • I additionally manage issues received from the Grievance and Appeals team sent for our offshore team to review
  • I’m in charge of ensuring associates review the issues and complete them by the due dates
  • With managing this work, I have learned to become extremely detailed with how the work is worded, structured, and the type of support needed to prevent the IRE from overturning a claim
  • I manage the email inbox for these issues as well and handle any pushback or escalations regarding the completed reviews
  • I will educate associates on any errors made with the reviews and update any processes needed to help make sure reviews are completed accurately
  • I oversee reviewing claims returned from the IRE on a weekly basis and present these issues during a cross team meeting
  • I also complete any work received from management, such as escalated issues to review and DOI complaints within the needed time frame
  • From managing multiple offshore and onshore teams I have learned to become more organized and thoughtful with how I structure my daily work and tasks
  • I have also learned better communication skills through managing the work of others and trying to maintain consistency

Coder - CPC

Humana Inc.
05.2014 - 08.2021
  • In this position I review provider billing disputes from Humana’s code editing database
  • I use my knowledge of coding denials and medical billing to review denied claims and determine if they denied due to an internal error or if the provider billed incorrectly
  • I will research the claim information with CRM, CAS, or MTV
  • I also utilize the vendor tools Claimsxten, Cotiviti, Nucleus, and Optum for detailed denial information
  • I will then call the provider back to inform them of my research results and advise on how they can proceed to either correct the claim or if the claim denied in error
  • If claims deny in error I send to the correct team to have them reprocess
  • I also work on larger group projects for those companies that have a high volume of claim issues and orchestrate monthly calls with them to discuss the inquiries
  • From managing these calls I have learned to do detailed work with high level of accuracy and have developed excellent interpersonal and communication skills

Specialist

Humana Inc.
04.2013 - 05.2014
  • In this position I input data into Humana’s code editing database from inquiries our customer service department sends over from provider’s phone calls
  • Once I have entered in the information from our customer service department, I will research the member’s information with CCP2, CAS, or MTV, and fill in any additional information needed
  • I will then call the provider back to inform them that we have the inquiry and will have a coder review the issue
  • I also research any emails received in the code editing email inbox and create new inquiries from them, or have them worked further by a coder

Administrative Assistant; Provider Payment Integrity Department

Humana Inc.
01.2012 - 04.2013
  • In this position I work with MTV, CAS, and MRM on a daily basis
  • I upload medical records which I receive in CCP2 into MRM database, and I help transfer claims to be reprocessed
  • I also call providers and request itemized bills to be loaded into MRM database, and I use the EFR system to call and confirm a patient’s admission date and to confirm if they had other insurance pay for their stay
  • Once a month I will also call a list of providers given to me to get their fax number so Humana can fax them updated Coordination of benefits information

Front Desk Clerk

Mussleman Hotels
04.2007 - 01.2012
  • Perform daily tasks for upcoming arrivals/checkouts, and manage all duties for the front desk
  • Responsibilities include professionally answering all incoming calls, preparing all necessary items for the day’s arrivals and checkouts, warmly greeting guests, providing excellent service in response to guest comments/concerns, ensuring an organized and delightful environment, and keeping gift shop stocked and organized

Education

Bachelors of Arts - Communications

University of Louisville
05.2020

Associates in Arts -

Bluegrass Community and Technical College
Lawrenceburg, KY
05.2017

Certified Professional Coder Certification -

AAPC
05.2014

High School Diploma -

Eastern High School
Louisville, KY
05.2006

Skills

  • Medical billing
  • HCPCS coding
  • Attention to detail
  • Coaching and mentoring

Recognition

  • 10/01/24, Star Award Nominee, Humana Inc., Awarded for positive reinforcement and exceptional leadership skills.
  • 07/01/11, Employee of the Quarter, Mussleman Hotels, Awarded for outstanding customer service and positive attitude.
  • 12/01/09, #1 Front Desk of Company Properties, Mussleman Hotels, Recognized for handling guest requests and concerns satisfactorily.

Certification

  • Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC).

Timeline

Team Lead - CPC

Humana Inc.
04.2024 - Current

Supervisor - CPC

Humana Inc.
10.2023 - 04.2024

Team Lead - CPC

Humana Inc.
08.2021 - 10.2023

Coder - CPC

Humana Inc.
05.2014 - 08.2021

Specialist

Humana Inc.
04.2013 - 05.2014

Administrative Assistant; Provider Payment Integrity Department

Humana Inc.
01.2012 - 04.2013

Front Desk Clerk

Mussleman Hotels
04.2007 - 01.2012

Associates in Arts -

Bluegrass Community and Technical College

Certified Professional Coder Certification -

AAPC

High School Diploma -

Eastern High School

Bachelors of Arts - Communications

University of Louisville

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Stephanie Lyons