LORA S. HARRIS

PO BOX ******

SACRAMENTO, CA ****1

916-***-**** Cell Phone

916-***-**** Business Phone

CAREER OBJECTIVE A responsible position in the day to day operations of a business entity with growth potential.

EDUCATION: Bachelor of Arts Interdisciplinary Studies with an emphasis in Paralegal Studies, National University, Certificate in Paralegal Studies, National University, Winterstein Adult Center, Medical Assistant Program: Medical Terminology, front and back office, medical insurance, private and group insurance, Workers’ Compensation, Champus, State Disability, Medicare and Medi-Cal, ICD9 and ICD10 CPT Coding, CPR Certification and Electrocardiogram. Business Programs: Microsoft Word, Microsoft Excel, Versyss Systems, Medi.com, MedSeries4 (MS4), Health Data Exchange (HDX), Document Imaging, OTR, Midas, Conquity, Right Fax; Cirius; NThrive; EPIC; Document Imaging; Safety Team Coordinator; Capability of doing Telework from home; COVID Clinic Medical Office Support.

WORK EXPERIENCE - Robert Half – Medical Office Receptionist: 04/02/21 05/30/21 Sacramento, CA Duties were: Support for COVID Medical Clinic registering patients for the COVID vaccine; helping them fill out paperwork if necessary and directing traffic to the COVID vaccine vaccinators. This position was weekends only.

R1 Global Marketing LLC – Claims Processor II: 11/06/22 to Current, Sacramento, CA Duties are: Sutter Health outsourced Rev Cycle division with the same job and job description working remotely processing and resolving claims and Appeals for Sutter Health.

Claims Processor II Rev Cycle - CBO Representative: 05/03 – 11/04/22 Sutter Health Shared Services, Roseville, CA Duties are: Support the delivery of all billing services by final/higher level auditing, correcting, and submitting HMO, Medicare Managed Care, Medi-Cal Managed Care, POS, PPO and Capitation claims. I process all claim related follow-up on payment delays, taking corrective action to finalize account disposition, performing all aspects of hospital/facility billing per contract as well as filing Appeals to the Payer. Knowledge of medical terminology; medical coding; various insurance documentation requirements and patient accounting system. Knowledge of HIPPA regulations. Ability to communicate with patients, physicians, associates, leadership, and providers. I am able to prioritize and resolve and escalate complex problems promptly and work with minimal supervision. I have a high level of problem identification; mitigation; and resolution and analytical skills.

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Non-Government Electronic Claims Processor: 12/01 - 05/03 Manpower Temporary Services, Sacramento, CA Duties were: Auditing claims for medical or hospital services prior to billing to ensure all documentation is accurate; electronically billing UB92’s, as well as HCFA1500 claim forms, documenting patient accounts, contacting patients, insurance companies as necessary to complete billing process.

Medical Claims Examiner: 9/99 - 11/01 Insurance Overload Systems, Sacramento, CA Duties were: Processing medical claims for professional services for IPA commercial claims, processing tracers, correspondence, working pended claims, processing vision claims.

Medical Instructor/Medical Biller/Medical Administrative: 4/99 - 9/99 and 10/01 -11/01 Med Temp Personnel, Citrus Heights, CA Duties were: Instruction in medical office procedures for general insurance billing, coding, collections, billing medical claims for HMO’s, PPO’s, Managed Care, Commercial Insurance and Government claims; Authorizations.

Patient Accounting Representative: 8/95 - 3/99 Perinatal & Pediatric Specialists Medical Group, Sacramento, CA Duties were: Processed medical claims accurately, verified accuracy of followed-up on patient accounts to payors; processed denials and appeals and resolved aged accounts; processed claims for HMO’s, PPO’s, Managed Care and commercial accounts. Extensive knowledge of computerized billing programs. High degree of initiative, judgment, discretion and decision making.

Medical Coder: 2/89 - 8/95 C.A.S.E. Medical Group, Sacramento, CA Duties were: ICD9, CPT, ASA coding for medical billing company; processed medical claims for a group of Anesthesiologists; follow-up on rebills, answered phones; Medicare; Medi-Cal and private insurance billing; Workers’ Compensation; HMO’s; PPO’s; Managed Care.

REFERENCES: Available upon requests

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