Lesa Connolly

***** * ******** ** #*

Spokane, WA 99208

509-***-****

advlt1@r.postjobfree.com

I’m seeking new career challenges and am interested in your organization by joining as your number one team player. I’m a fast learner and egger to get started.

Experience:

May 2012–May 2019

Charge Entry Specialist * Cancer Care Northwest

My specific skills and abilities are excellent on accuracy, detail in Reviewing proper documentation & scrubbing Radiation charges for a 11 Radiation Oncology Doctors. I met my daily goals by, scrubbing 150 to 250 charges a day. Working closely one on one with 4 Dosimetrist on patients planning (IMRT, SBRT & 3D) 6 Radiation Therapist on patients’ treatments by utilizing Mosqia Application, patients plan, how many treatments patients will be receiving during their course of their treatments. Or if BID is being completed twice a day. Another specific skill that gives me the ability to verify correct diagnosis with proper documentation for the patient’s plan. Another excellent skill I have is the ability to read a pathology report, CT scans, doctor orders, nurses note and new patient consults. I worked closely with the credentialing department with locums and new doctors coming in. I would work with them on with insurance companies the locums had qualify for. I was able to bill for correct insurances, and hold charges until the doctor/locum was certificated. By holding the claims, we did not have to rebill for the correct insurance. Transmit charges from application TRANSACT and export it into Centricity work queue by payers & labs. Then at the end of the day I would export all worked charges through our application ACE to go to the Medicare Clearing House for payment or rejected claims. Next morning, I would work all rejected claims and reprocess them for payment. I also answered Follow up on emails regarding, “missing modifiers, incorrect DOS, Incorrect CPT Codes/diagnosis. I would review all documentation and correct the claim. I email Follow up and let them know what I have changed & corrected it too, ask Follow UP to reprocess for payment. I reviewed & scrubbed Inpatient hospital charges for Medicare, and all Medicare plans. I would do split charges between the hospital and Medicare. By using EPIC, I was able to verify admitted dates, release dates. I was able to determine how long to bill Medicare/hospital inpatient codes with the correct modifiers and DOS, plans and how many treatments they would receive while in the hospital. I was able to perform a variety of duties, often changing form one task to another of different nature, with impending deadlines and /or established timeframes. I performed very well with frequent interruptions and distractions. I can work independently, with minimal supervision. I also have strong analytical and problem-solving skills.

Experience: December 2011 – May 2012j

Spherion Staffing & Recruiting -Temp

Cancer Care Northwest

As a temp at CCNW my duties were. Assisting the patient advocates with their follow up for oral drugs and Bart/BRC testing. Assist front desk with their daily work, such as scanning insurance cards for update plans & coverage. I would scan the Medical Cards into the patient account and verify insurance. Effective Date, what kind of plan they have, if it requires Authorize or not. Make sure we got the front & back of the medical cards scanned into Aria. I would communicate with the patient advocates by email when a authorize was required. I assisted CCNW Radiation Oncology Coder with Charge Entry’s claims, Medicare appeals I, II, III. I was able to get old DOS that was in sage II appeal status, by digging and finally finding the old documentation in the archives of the basement. I was able to add it, explain our case and prove it was Medically Necessary, the decision was in our favor. It was $28,000 of old money. My ability to take initiative, effectively and detail oriented. I was able to establish a paper trail of this patient plan and was able to add the documentation as proof of being Medically Necessary.

Experience:

April 2005 – November 2011

LineCare Inc.

Patient Account Coordinator II

I have excellent Customer Service Skills! I multi-task by juggling multiple projects. Such as working 120 days report getting the old money in. As will working 30, 90-day reports and getting the claims corrected and reprocess for payment. At the same time calling insurances companies, (Medicare, Medicaid) asking why thy had denied our claims. Due to my detail-oriented personality I was able to get most of them paid. Because I know just by looking at the claim what was missing. Such as a modifier, DOS do not match, diagnosis, Composed account numbers etc. I wrote off charges, due to late filing, not having proper paper work, documents not signed and write offs requested from Lincares management staff. I would answer patient calls, correct claims and resubmit them for payment. Most of the calls was because, they couldn’t get a new CPAP for 5 years. I would have to explain to the patient why Medicare did not approve or pay for the procedure or equipment. Those were hard calls. But it was very educational and gave me the ability to use sound judgment, work independently with minimal supervision. I was able to put the patient on a payment arrangement which please the patient for the most part. Not all patients, but was nice to have something to offer them. I would even talk to them about picking up secondary insurances like, AARP, Aetna, Medicaid if they had Medicare as their primary insurance.