LISA BENSON

* * * ***** * t r eet – Box ***, P a l mer L a k e, CO 8 0133

P hone: 5 3 1 . 3 2 9 . 9 049 l e e smgerken@hotmail.c om Insurance & Financial Counseling/Billing & Coding/Prior Auth Specialist/Leader Insurance knowledge and expertise ~ Financial and Insurance expert ~ Claim analysis and auditing ~ Customer Service Professional Skilled business professional, experienced in health insurance billing/coding, financial counseling and benefits. Meticulous in all aspects of claims analysis, medical coding, and medical procedures. Advanced customer service ability; accomplished at learning new concepts quickly, working well under pressure and communicating ideas clearly and effectively. Analytical, highly motivated, accountable and self-driven. Experienced in negotiating for prior authorizations and investigation and appeal of service-level denials. Hard-working, efficient, and accountable. Skill set attained through years of experience in medical health insurance and cutting-edge professional training.

• Medical terminology interpretation • Medical coding • ICD-10/CPT-4 coding expert

• 10-key by touch • Skilled at multi-tasking • Wide medical plan knowledge

• Strong oral and written skills • Diplomatic and tactful • Trustworthy, discreet and ethical

• Punctual and adaptable • Disciplined team player • Computer/POS scanning CAREER ACCOMPLISHMENTS

Rocky Mountain Cancer Centers

• After only 4 weeks on the job as an extern, was given sole responsibility and trust in order to run the billing and insurance office on a solo basis

• Received letters of recommendation from coworker and supervisor at extern site The Principal Financial Group

• Consistent top claim producer, attaining over 90% accuracy rate and production of above the stated goal of medical claims completed per day

• Assisted supervisory staff with claim audits of peer claim production

• Mentored and trained inexperienced staff, as well as retraining/coaching as needed Linens N’ Things

• Recognized by corporate office for delivering unparalleled customer service Choices Weight Loss Centers

• Established client base for new clinics in the Denver, Colorado area. Acknowledged for closing ratio of new sales of 80% and retaining existing client base.

PROFESSIONAL EXPERIENCE

WHOLE KIDS CO. – Colorado Springs, CO 9-6-2022-Present A multi-disciplinary Counseling and Autism center

Intake Coordinator

• Provide oversight of the intake process and case assignment, as required

• Complete referrals and schedule intake appointments

• Perform registration of all incoming clients

• Schedule intake appointments for all therapists

• Facilitate verification of benefits for all patients through various online portals

• Receive and process all required client information for new clients

• Engage with clients and providers in written and phone contact as required

• Initiate follow-up and confirmation of appointments for providers

• Provide stellar communication and interpersonal service to clients, internal peers, and subordinates

• Extend excellent problem-solving skills as required

• Compose clear and concise written communication

• Provide stellar customer service in phone and/or written (email) format

• Afford strong, professional customer service

• Utilize office skills and working knowledge of office management and filing systems

• Deliver excellent organizational and time management skills Lisa Benson Page 2

PROFESSIONAL EXPERIENCE

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BOYS TOWN NATIONAL RESEARCH HOSPITAL – Omaha, NE 10/19/2020-7/30/2022 National Research Hospital that offers a broad range of surgical and clinical services Prior Authorization Specialist – Surgery/Radiology

• Completed benefits investigations with patient health care plan by phone or on Internet

• Performed all-inclusive benefits review of patient benefits, deductibles, out-of-pocket and potential coverage with client

• Provided detailed elaboration of pre-authorization requirements and potential costs to client

• Enabled billing department client referrals to discuss repayment plans after explanation of benefits/payment received

• Facilitated all prior authorizations of high-tech radiology and surgical services for national research hospital physicians

• Directed all prior authorization of drug infusions/injectable specialty drugs

• Provided oversight and completion of the appeals process for authorization denials THINK WHOLEPERSON AKSARBEN – Omaha, NE 8/17/2015 – 10/18/2020 A unique doctor-led primary care clinic bringing a new standard of care to Omaha, NE Pre-authorization Specialist

• Performed comprehensive investigations of patient health care plan by phone or on Internet

• Completed detailed review of patient benefits, deductibles, out-of-pocket and potential coverage with client

• Presented thorough explanation of pre-authorization requirements and potential costs to client

• Supported billing department client referrals to discuss repayment plans after explanation of benefits/payment received

• Facilitated all prior authorization of high-tech radiology services for in-house or outside of clinic for patients of 30-physician primary care clinic

• Provided oversight of all prior authorization of drug infusions/injectable specialty drugs for clinic patients

• Managed the appeals process for authorization denials NEBRASKA CANCER SPECIALISTS – Omaha, NE 2/1/2010 – 7/31/2015 The regional leader in cancer diagnosis, treatment, and research Billing and Prior Authorization Specialist

• Facilitated all prior authorization of imaging studies for staging and restaging cancer patients

• Reviewed, process, and audit the medical necessity for each patient’s chemotherapy treatment

• Documented all regiments and pathway adherence including review of ICD-10 diagnosis codes

• Obtained insurance authorization and pre-certification for chemotherapy services

• Communicated restrictions or special requirements of specific insurance plans to nursing and medical staff

• Provided prompt, accurate feedback to physicians regarding documentation issues and/or payor issues with non- covered chemo drugs or treatment

• Afforded strict adherence to NCCN (National Comprehensive Cancer Network) guidelines for obtaining authorizations ROCKY MOUNTAIN CANCER CENTERS – Sky Ridge Medical Center, Lone Tree, CO 2009 Colorado's largest and most comprehensive provider of cancer care Billing and Coding Intern

• Insurance and referral verification

• One-on-one financial counseling regarding benefits, payment plans, and client responsibility for payment

• Patient charge posting in client computer system

• Edit review and correction

• Insurance information updates in Centricity (internal computer system)

• Patient counseling regarding initial billing statements and potential payment plans

• Answered pending claim questions on an independent basis Lisa Benson Page 3

PROFESSIONAL EXPERIENCE

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PREMIER GNATHODONTIC LAB, Denver, CO 2007-2008

Dental laboratory specializing in fabrication of study models and dental appliances for local and regional orthodontists Laboratory Assistant

• Assisted manager with model preparation for fabrication and study models for orthodontic customers

• Provided support for billing and general office duties GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY and 1995 THE PRINCIPAL FINANCIAL GROUP 1984-1994

Leading providers of employer-sponsored medical insurance plans Senior Claim Examiner

• Utilized knowledge of medical terminology, ICD-9 coding, CPT and DRG codes

• Accurately processed medical, dental, and hospital claims

• Assisted supervisory staff with audits, peer training/mentoring of new employees

• Adjudication and adjustment of difficult or complex claims

• Performed COB adjustments and payments and third-party claims

• Adjudicated complex pended claims, pricing, and subrogation

• Facilitated Medical necessity review and pre-existing evaluation

• Reviewed medical records and discussed findings with providers and members

• Developed deep knowledge of HMO, PPO, POS and Medicare plans ADDITIONAL EXPERIENCE

LINENS N’ THINGS, Littleton, CO 1999-2008

CHOICES WEIGHT LOSS CENTERS, Castle Rock, CO 2004

UTILITIES DEPARTMENT WATER CONSERVATION, Castle Rock, CO 1999-2002 DEIS DATA ENTRY SPECIALIST/TRANSCRIPTIONIST, Denver, CO 1995-1996 EDUCATION

CONCORDE CAREER COLLEGE, Denver, CO 2009

Insurance Coding/Billing Specialist Certification - 4.0 GPA

• Medical terminology

• Software applications

• ICD-9 and CPT-4 (Medical Procedure) coding

• Insurance classes (Medicare, Medicaid, BC/BS, etc.)

• Externship at Rocky Mountain Cancer Centers – Sky Ridge Medical Center, Lone Tree, CO

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