Insurance Manager
Resume:
MaryAnne Lawley
Billing/Coding Supervisor
Waterbury, CT - 06708
WORK EXPERIENCE
Billing/Coding Supervisor
Greater Waterbury Retina, LLC - December 2006 to November 2012
Managed all coding and billing surgical charges and daily electronic submission of all charges to clearinghouse.
Followed up on all denied claims by phone or by formal written appeal when warranted.
* Developed spreadsheets to track patients who received intravitreal injections of costly medications, i.e. date
of service, patient's insurance company, when claim was paid and the amount of the payment.
* Monitored payments and made sure they were paid correctly; filed appeals or submitted corrected claims
which ever method was appropriate - Office Manager was very pleased with the spreadsheet as it worked as
an invaluable tool for her needs as well.
* Balanced daily AR reports and monthly reports; coded all surgeries and verified coverage and benefits for
all patients scheduled for surgery and entered surgery date in computer system.
* Processed billings to patients and third party reimbursement claims; maintained supporting documentation
files and current patient addresses.
* Processed patient statements, keys data, posts transactions, and verified accuracy of input to reports
generated.
* Researched and responded by telephone and in writing to patient inquiries regarding billing issues and
problems.
* Followed up on submitted claims; monitored unpaid claims, initiated tracers; and resubmitted claims as
necessary.
* Balanced daily batches and reports; prepared income reports and statistics; and distributed reports.
Surgical Claims Coordinator
Opticare Eye Health Centers - November 1994 to December 2006
Responsible for all pre-certifications, coding and insurance billing including reviewing of open surgical claims
and resolving claims issues.
* Filed written appeals on denied claims while reconciling surgical and Ambulatory Surgical Center fees with
month end charge reports.
* Pursued surgical receivables for 10+ surgeons, reviewed coding and post all surgical charges, and filed
electronic ASC claims to Anthem Blue Cross.
* Provided education and support to front end staff; scheduled surgeries for patients and maintained calendar.
Initiated insurance pre-certification, obtained medical clearances, and processed insurance claims.
Insurance Counselor * Opticare Eye Health Centers
* Advised patients on financial responsibilities for upcoming surgical procedures.
* Worked with patients to resolve billing issues, filed claims to insurance companies, and worked daily reports
to follow up with insurance companies on claims problems.
* Provided friendly caring service to customers while promoting organization's products and services.
* Processed insurance claims and counselled customers, and relatives of customers, concerning death and
disability by performing the following duties.
* Helped individuals and businesses select insurance policies suited to their particular needs.
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