TONYA LUCAS

Email: abqkb2@r.postjobfree.com

Address: ***** ** ******* ****

City: ST ANN

State: MO

Zip: 63074

Country: USA

Phone: 314-***-****

Skill Level: Management

Salary Range: $52,000

Primary Skills/Experience:

See Resume

Educational Background:

See Resume

Job History / Details:

Tonya Lucas, CPC

11019 St. Ambrose Lane, St. Ann, MO 63074 Phone 314-***-**** Email abqkb2@r.postjobfree.com

Enthusiastic, multi-disciplined professional seeking to be an integral member of an organization that prizes personal integrity, leadership performance and outstanding results.

Leadership Skills: Demonstrating a positive attitude, strong work ethic, loyalty and dedication; considering the impact of decisions on the department, obtaining cooperation; utilizing logic and sound judgment in decision-making; diplomatic, setting an example of integrity

Administrative Skills: Ensuring accountability of subordinates related to conduct and productivity; quick to recognize problems and execute solutions; systematically securing relevant information and identifying key issues; paying attention to detail; structuring tasks, plans and objectives to establish priorities and set goals

Human Resource Skills: Interacting effectively with individuals in all levels; fostering a spirit of cooperation and respect; leading by example; making recommendations based on research and familiarity with various elements; soliciting ideas/opinions of others and utilizing input on key issues; encouraging and providing training

Communication Skills: Expressing ideas (written and orally) in an articulate, clear, concise, and effective manner

Computer Skills: Windows NT, 9x, 2000 and XP, EDI, AS/400, MS Office, Quick Books, Word, Excel, IDX, Medical Manager, Medisoft, AMISYS, NASCO, EDS, TBS, Chiro7000, PRUCARE, QSTAR, RIMS, COSMOS, UNIX, Outlook

Areas of expertise:

ICD-9, CPT, HCPCS Coding Medicare/Medicaid, DMH

Claims auditing/adjusting Managed Care Plans-HMO, PPO

A/R Follow Up Insurance authorizations

Appeals and Grievances Customer Service

Cash Posting/Collections Spreadsheets, budgeting, reporting and tracking

Professional Experience:

Billing Manager, Howard Park Center, Ellisville, MO Nov 2011-present

Perform responsibilities of managing and controlling department budget, cash flow, and account receivables

Responsible for maintaining billing procedures, electronic billing functions, ensuring accurate billing activities

Handle the tasks of conducting audit of quarterly billing to ensure accurate payment

Reconciled billing reports, responsible for collection actions and follow up

Negotiated and resolved billing discrepancies, analyzing account receivables, and updating practice fee schedules, negotiated contracted rates with commercial insurance companies

Performed the task of coordinating clinical information to receive pre-authorizations as required

Responsible for maintaining database as well as operation of accounts receivable ledgers

Handled responsibilities of providing training to new billing staff to ensure effective work flow

Perform the tasks of developing, evaluating, and maintaining billing and collection systems

Review, coordinate, and update all compliance issues regarding federal and state rules and regulations

Maintained credentialing for all providers through CAQH, NPPES and other agencies as needed

Assign medical codes for procedures and diagnoses to generate bills for reimbursement

Designed current superbill

Providing patient financial counseling, tracking payment and payment plans

Collector, Client Services Inc., St. Charles, MO Jan 2011-July 2011

Providing excellent customer service, negotiating settlement arrangements and payment plans for the cardholders

Achieving and exceeding collection dollars/call goals on a monthly basis

Maintaining client database information

Bookkeeper, Apollo Realty, St. Louis, MO 2009-2010

Paid and recorded all accounts and bills for both incoming and outgoing transactions

Issued payroll at the required time schedule, including legally required deductions or withholdings for tax purposes or for other reasons

Verified accuracy of work performed by others when updating ledgers and other financial statements

Corrected and reconciled any discrepancies in ledgers, accounts, or other financial statements

Compiled statistical, accounting, or auditing reports for cash receipts, accounts payable, accounts receivable, profit and loss

Revenue Cycle Solutions Rep., Perot Systems, St. Louis, MO 2007-2009

Reviewed and researched a high volume of medical claims both manually and electronically submitted

Effectively communicated both written and orally with providers, members, collection agencies, attorneys

Maintained databases for providers and members

Handled medical claim adjustments, appeals, audits and coding issues

Followed up on all claims to final resolution, monitoring coding and procedural trends on Excel

Analyzed daily balance and end of month close

Electronic Claims Specialist, CorVel Corporation, St. Louis, MO June 2006-October 2006

Sorted, stamped, organized all correspondence that came into the office, and scanned bills for all clients

Reviewed and adjusted work comp, auto and liability claims

Accountable for database administration - including fee schedules and demographics

Facilitated follow-up, collections, appeals, overpayments and adjustments to claims

Provided excellent customer service

Balanced month end close

Auditor, OfficeTeam Healthcare Group, St. Louis, April 2006-May 2006

Reviewed and extracted charts for SIP and Pneumonia populations (completed project several months ahead of schedule

Office Manager, Metro Rehab Physicians, St. Louis, MO 2005-2006

Supervised 10 offices with 4 physicians, 1 nurse practitioner and all office staff

Organized physician`s schedule and maintained credentialing

Processed end of month close and payroll, balanced quick books on a monthly basis, followed up A/R, posted all insurance and patient payments, reviewed appeals and made adjustments when appropriate

Purchased medical and office supplies for central billing office and amended current policy and procedure manual

Monitored and maintained computer database, including current patient information, fee schedules, cpt codes, icd-9 codes, and insurance information on Medical Manager

Accountable for all medical coding for both inpatient/outpatient claims and kept office staff updated on new policies and procedure, interviewed, and organized benefits such as medical, life, payroll, 401k/pension plan

Conducted weekly/monthly office meeting for physicians and office staff

Biller, Healthcare Strategic Initiatives, St. Louis, MO February 2005-May 2005

Handled billing and cash posting

Provided excellent customer service, including both written and phone contact

Maintained databases for providers and members

Responsible for medical coding, appeals, adjustments and refunds

Reprocessed complicated claims and followed up to claims resolution

Analyzed daily balance and end of month close

Senior Customer Service Rep., Jacobson Associates, Chicago, IL 2004

Developed payment plans to helps patients managed payment of bills

Posted payments to accounts in computerized system

Updated insurance companies or other third parties to secure payment

Replied to all patient billing and statement inquires in a timely manner

Employment Placements through Midwest Claim Consultants:

Zenith Administrators, Earth City, MO 2003-2004

Medical Data Systems, Creve Coeur, MO 2002

United HealthCare of The Midwest, St. Louis, MO 2000-2001

Health Partners of The Midwest, Clayton, MO 1999-2000

Westport Benefits, Brentwood, MO 1998-1999

HealthLink HMO, Creve Coeur, MO 1995-1997

Education and Certifications:

Bachelor`s Degree in Business Administration 2005

Majored in Business Management, Minored in Organizational Behavior

Graduated Magna cum Laude-GPA 3.78

Certified Medical Coder 2004

Graduated from A Technological Advantage-GPA 4.0

Certificates in Medical Terminology and Anatomy

References Available Upon Request

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