Laura Clemmons

**** ******** **.

Lansing, MI ***11

517-***-****

ad23jf@r.postjobfree.com

OBJECTIVE

A mid-level management position in receptionist and medical billing. Great customer service in public relations, requiring strong organization skills and dealing with large task for creative thinking abilities people in need of assistance with health insurance along with health needs.

SUMMARY OF QUALIFICATIONS

Management skills, customer service, computer skills, windows, micro soft word printer, fax, coping machinery, scanner, phone operator, medic systems, Kareo system, EHR, Med touch, office billing/coding and other various office equipment/software use.

EXPERIENCE

Clerical/Medical Biller

Springer Prosthetics & Orthotics Services, Lansing, MI

09/2017 to Present

Joining the Prosthetic & Orthotics team, my goal was to ensure the billing for patient care and office was first priority. I worked denied claims thru Zirmed system, submitted authorizations/pre-authorizations, redeterminations and appeals to insurances companies as needed in timely manner. I met face to face with patients to inform them of any % reimbursements, deductible, coinsurances due before services are rendered. I worked EOB, s from insurance carriers that explains the response for action. I answered phones-direct to applicable individual or practitioner. I scheduled patient’s appointments, input patient demographics into OPIE system, scanned prescriptions, Doctors chart notes into electronic record keeping, and other clerical/billing requirements that were needed.

DME Medical Biller

Crown Quest, INC., LANSING, MI

06/2016 to Present

As a DME Biller my job duties included, Contract terms, Fee schedule variables, modifier usage, payers specific billing requirements, setting the payers billing companion guides that instruct on data requirements for billing certain medical devices. Understanding of medical terminology is beneficial for proper interpretation, coding of claims and determination of medical necessity when reviewing physical documentation. Reviewing online training, billing training, study denials to develop solutions and validating their findings directly with the payers, other team members and myself. Review all DME referrals, verify insurances, make and receive phone calls, and all other receptionist duties that are required of me.

Review Specialist

Inovalon, Lansing, MI

01/2013 to 03/2014

As a Review Specialist I worked as a Medical Data Review Coordinator. I was responsible for contacting sites for record requesting and following up on requested records for CMS reviews. I also performed Doc Processing and Pre-Processing documents in a timely manner for which project deadlines were to be met. I reviewed medical records daily as part of my daily routine and was to make sure Health Plans were satisfied with getting all the records needed to meet the requirements for CMS. I worked with Microsoft word, PowerPoint, med net, excel spreadsheets, and other various computer skills along with other various task that was required of me.

Medical Biller

Lansing Orthopedic P.C, Lansing, MI

05/2003 to 08/2012

Medical Biller- Prepared daily schedules, scheduled appointments, verified patient’s active insurance policies. made calls to various insurance company and their representatives for insurance questions, verified payments over 30 day due accounts. answered/transferred phone lines from switchboards to appropriate persons. Note taking, take messages for personnel. Entered patient account information, submit billing codes for Doctors daily.

EDUCATION & TRAINING

certifications, medical administration, Davenport University, MI

Clerical/Medical Biller, Career Quest, Lansing MI, 1 year

diploma, math,English,social studies, general studies Lansing Sexton High School/Lansing vocational, MI

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