KATHLEEN MCCLEMENT-LANSLEY

**** ***** ****, ******** ***, NY 12020

518-***-****/518-***-****

adzl3n@r.postjobfree.com

OVERVIEW

A highly motivated Credit, A/R, A/P, and Collections Professional with a verifiable record of accomplishment spanning over twenty years. Highly creative, recognized as a results-oriented and solution-focused individual. Areas of strength include:

• Supervisory Experience

• Accounts payable

• Computer Literacy

• Work as Team Player

• Tracking of claims

• Customer Service

• Accounts Receivable

• Legal Aspects of Collections

• Communication Skills

• Time Management Skills

• Research Abilities

EDUCATION

Milne High School, Albany NY

Albany Business College

COMPUTER SKILLS

• Computer literate in many billing programs

• WordPerfect, Microsoft Word, Outlook

• Excel levels, 1, 2 & 3

• PowerPoint 1

• Fee 101

• CCMS training and seminars.

• Vista and ECAMS

PROFESSIONAL EXPERIENCE

Lead Voucher/Examiner

Stratton VAMC, Albany, NY 12208

• Handling escalated issues in payment, documentation that is needed, and benefits. Working with the Appeals department as well as CRM and ACR documenting the phone call and action taken.

• Processing of Bene Travel claims per legal standard for the Mission Act

• Processing of Pharmacy claims against Mission Act. Setting claims up in the ECAMS system

• Ensuring the proper notification was in for 72 hrs. with ER and inpatient, whether it be over the phone or from notes in CPRS.

• Speaking with Veterans in regard to their medical benefits.

• Training and mentoring other staff

• Assigning proper obligations to services and analyzing other claims to ensure the correct obligations and funds are used.

• Working special projects as assigned in Excell spreadsheets

• Analyzed claims for correct information

• Assisted Budget Technician in Bills of Collection and making sure enough money was in the funds to pay claims.

11/2018-5/31/2022

Grade 7 step 6–step

7

Claims Examiner

Stratton VAMC, Albany, NY 12208 Veterans Medical Center 9/28/2008 –11/2018

Grade 5-6 step7

• Full charge processing consults for Non VA Care for Albany also handling the Dialysis for the New York State Region encompassing 5 sites for over 3 years

• Extensive work with Medicaid billing,types of eligibility for Medicaid such as spindown, diagnosis driven, in or out patient only, documentation needed for certification of certain services

• Customer Service handling incoming calls from Veterans and vendors

• Office Correspondence

• Determines eligibility for medical benefits per the established guidelines.

• Reviews documentation so it can be medically review if appropriate

• Reviews claims for eligibility and entitlement of benefits for payment.

• Educates the Veterans and vendors in medical benefits what is required also protects sensitive information per HIPPA and government policy’s

• Works closely with other VA sites and at a national level for seamless befits for the Veteran’s that are traveling

• Properly authorizing claims to go to payment

• Has traveled to other sites to work with VA staff in changes in policy and training on what is needed to have services authorized.

• Works with Nation and local contracts also in negotiating fees

• Research issue and to help were ever needed.

• Attended and completed Medical Terminology class

• Has planned and conducted conference calls

• Did instruction for new coworkers as a group, also virtual training Billing Coordinator 2006-

2008

02 Solutions

Saratoga Springs, NY

• Billing, posting, deposits and month end reports and spreadsheets

• Working directly with Insurance companies and patients with A/R.

• Following government guidelines and regulations for Medicare and Medicaid Billing A/R Specialist

Account Temps/Renal Research Institute

2006-2006

• Accountable for Blue Cross Insurances in 14 facilities

• Payment collections for facilities

• 120+ A/R coordination of Admissions and monies with correct information

• Liaison for Connecticut Care for 3 facilities

Intake Coordinator/Medical Collections Specialist 2004-2005 Curative Pharmacy Services

Scotia, NY

• Verification of insurances to communicate with patients parents, hospitals, Physicians and Nursing Director to ensure the delivery of medications and services required by contractual obligations.

• Manage up to 70 referrals a day ranging geographically from Kingston, NY south to Long Island.

• Responsible for business to business collections including appeals processes collecting 400k quarterly.

Customer Service/Claims Processor

AETNA, Albany, NY

• Incoming and outgoing calls regarding claims, problem resolution and treatment authorizations.

• Cross-trained exclusively as one of a few representatives to make claim adjustments without additional approval for up to 3k.

• Routinely received performance bonus’ every quarter due to exceeding accuracy standards of 98.6 continuously.

Senior/Customer Service Representative 1999-2001

Value Options, Latham NY

• Trainer of new representatives, mentoring and supervising up to 15 staff.

• Claims processor, reviewing of authorizations, appeals and customer service.

• Back end scanning

ACCOMPLISHMENTS

• Coordination of Dialysis Program VISN Wide

• LPN Student

• Received many awards for outstanding performance and accuracy in multiple positions. SPECIAL INTERESTS

Family activities, raising dogs and Church functions. REFERENCES

Promptly furnished upon request.

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