Anne Lee-Clifton

*** *. ******* ***., ********, CA 95203 •209-***-****• adu6bh@r.postjobfree.com

Profile

Anne Lee-Clifton has been involved with Medical Claims Processing for the majority of her career. She has extensive experience providing timely and accurate review of ICD9/ICD10 and/or CPT4 code assignments as well as reviewing insurance policies in order to determine their medical benefit coverage. Anne is in search of an opportunity that will offer room for growth as well as stability.

Education

Heald College, Stockton, CA

Certified Medical Assisting, Graduate 2015

Anthem College Online, Phoenix, AZ

Associate of Applied Science Medical Billing and Coding Graduate 2012

Skills

●Microsoft Windows Office

●Proficient Typist

●Outstanding Customer Service

●Excellent Communicator

●Raw Claims Billing and Coding

●ICD9/ ICD10 Coding

CPT4 Coding

Work Experience

Mobile Med Work

Medical Assistant

August 2022 to present

Covid Tester

Oroville Hospital (remote, contract)

Followup Specialist

December 2021 to April 2022

●Followup with insurance on claims

●Updating Insurance as needed

●Billing claims to insurance

●Workermans Comp and private insurance

●Updating all patients Demographics

Pacific Medical Inc.

Billing Specialist, November 2019 to May 2021

●Billing claims for prosthetics and orthotics.

●Working with all insurances including Medicare and Medi-Cal.

●Requesting authorizations and eligibility.

●Calling patients to update demographics and insurance.

Norcal Ambulance

Biller/Collector, July 2018 to March 2019

●Correspond with insurance companies via phone, fax, and mail.

●Filed appeals on underpaid claims.

●Spoke with patients about their claims i.e. set up payment arrangements or for additional information.

●Rebilled corrected claims.

Zenith American Solutions

Claims Processor III, February 2016 to July 2017

●Adjusted and processed Medicare, Chiropractic, Dual Coverage/OIC, and Injectables/RX claims

●Prepared medical records and referral sheets for claims requiring medical necessity review

●Assisted with training new hire employees

Aerotek

Claims Processor (contract), September 2015 to December 2015

●Printed, submitted, and adjusted claims to insurance companies with medical records or primary EOB’s

●Prepared records in accordance with detail instructions, examine documents for accuracy and completeness

●Reviewed ICD9 and CPT4 codes; submitted pre-authorizations

Career Sparks

Authorization Specialist (contract), April 2015 to May 2015

●Data entry

●Prior Authorizations Management

Progressive Cash Flow Solutions (contract), June 2012 to June 2013

●Reviewed and analyzed medical information from medical records against billed charges

●Maintenance corrections as needed to ensure payment on denied claims and reimbursements

Blue Shield of California

Senior Customer Service Representative December 2000 to March 2010

●Quote benefits

●Processed claims

●Claims adjustor

●Updated work flows

●Assisted with new hires

●Worked on special teams

●Worked special projects

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