Lisa Gist

346-***-****

**** ******** ****** ***** **** 4202

Pearland, Texas 77584

adcdfv@r.postjobfree.com

PROFESSIONAL HIGHLIGHTS:

* ***** ** ***** ** experience as a Health Finance/Insurance Advocate in a busy environment.

Great ability to interpret rules and regulations set by commercial and government insurance policies

Excellent knowledge of Medical Terminology and billing procedures

Professionalism & Communication in Healthcare Setting

Highly organized with strong attention to detail with demonstrated ability to keep patients’ financial records in an organized manner using alphabetic and numeric listing systems

Thorough knowledge in reference to patient confidentiality and HIPAA compliance

Skilled in all EMR systems

EDUCATION AND CERTIFICATIONS:

DeVry University - Bachelor of Science in Finance Management– 2020

Brown Mackie College - Associate of Applied Science in Healthcare Administration - 2015

GPA: 3.45/4.0

PROFESSIONAL EXPERIENCE:

Insurance Verification Specialist – Clear Lake Dermatology Webster, TX

April 2019-Present

Complete Insurance Verification for office visit, surgical procedures, labs, and injections.

EFT/ ERA/ EOB Posting

Work with billing team to resolve denials and initiate appeal process

Ensured accurate data entry into healthcare verification applications (Availity, TMHP, United Healthcare, Navinet)

Implement training procedures for new hires

Claim Submission

Ran and processed accuracy of patient statements on a monthly basis

Quickly identified and resolved billing issues identified by insurance carriers and patients within billing cycle timeframe

Provide finance department with monthly revenue goals

Insurance Verification Specialist & Registrar - Northside Hospital Atlanta, GA

January 2017 – March 2019

Verified health insurance policies for all commercial and government agencies

Scheduled/Verified Surgeries for all three hospital locations

Obtained/ Initiated Pre-Certification

Follow up w/ Denials

Required to complete 40-60 accounts per day (minimum)

Productivity based environment

Bill for Collections

Prior Authorization Specialist - ProCare Prosthetics and Orthotics Atlanta, GA October 2013 – December 2016

Verify Insurance coverage for DME, prosthetics, and surgical procedures

Initiate Prior Authorization for all patients, input appropriate information in EMR system to track status

Over all scheduling for office IP/OP(including third party physical therapy and transportation)

A Financial Advocate throughout treatment process

Collect EFT & Cash payments, Post ERA’s, generate and send out statements

Ensure all remain active within care and up to date with all financials

Manage office paperwork – all incoming faxes are sent directly to me – responsible for contacting hospitals, physicians, and other offices when obtaining information, (i.e. Rx, Physician notes, medical records)

Enter all patient demographics in system

Responsible for ensuring the proper structure within the office daily

Accounting Assistant (Internship) – Ewing Chiropractic LLC, Stockbridge, GA December 2012 – September 2013

Responsible for collecting co-pays, handling bill reductions and verifying/explaining all med pay and insurance information to patients.

Utilized quick books to balance revenue

Responsible for AR/Claim Follow Up

Responsible for explaining financial responsibility to patients

Responsible for recruiting, hiring and training of all staff

Responsible for creating monthly budget spreadsheets

Responsible for creating expense reports and sending out invoices

Responsible for managing calendar for owner

Contact this candidate