Billing Specialist Accounts Receivable

L o r i Vo o r d e

South Bend, IN • 616-***-**** • ***********@***.***

PROFESSIONAL EXPERIENCE

Logan Center

Accounts Receivable Manager

August 2023-Present

South Bend, IN

• Maintain all LOGAN billing and client information as required.

• On a monthly basis, calculate and generate reports to determine the aggregate billing ratios for

pre-voc and facility group hab services prior to

• electronic submission of waiver billing.

• Data entry into various funding source manual billing modules and post revenue as required.

(Includes First Steps and EDI/HP claims not submitted electronically through Intuition).

• Monitor, bill and submit reimbursement paperwork for First Steps Therapists including contracted

employees

• Monitor, bill and approve all Respite and Transportation vouchers received from day service

programs and submit to AP for processing.

• Monitor waiver payments for over-utilization and coordinate with appropriate staff for revisions

• Managed relationships with Logan Software Project Manager and outside Software

Representative as needed to verify the accuracy and recommend more efficient procedures

• Monthly monitor Logan Group Home Client AR and send out past due notices when sending out

Rent invoices as needed.

• Oversee all processes related to auditing

Center for Hospice Care May 2022-August 2023

Billing Specialist/Verification Mishawaka, IN

• Process and submit all Home Health and Hospice claims in a timely and accurate manner

• Oversee the daily needs of all outstanding patient accounts and manage mediated patients

paperwork

• Manage regular communication channels with Medicare billers and all external insurance

agencies concerning processing and payments

• Verify medical benefits for commercial, Medicare, and Medicaid

• Process and submit all hospice claims to Medicaid on established timelines

• Oversee the organization of AR and billing in a routinely updated filing system

Coordinate with referral specialists and intake coordinators to ensure proper coverage details

• Provide guidance to colleagues and serve as a department resource regarding Home Health and

Medicaid billing issues

• Supervise daily discharges including reporting updates to daily census, collaborating with key

staff and following up with timely discharge reports

G o s h e n H e a l t h April 2020-February 2021

Surgical Statistics and Billing Specialist South Bend, IN

• Managed all activities related to Operating Room including customer service relations,

performance metrics, inventory management, and supply costs

• Maintained patient data and charges in the electronic billing system for charge capture and

monitored charge

• Verified medication charges into Meditech to ensure correct billing for all ongoing procedures

• Managed billing and finance issues in coordination with insurance companies, patient financial

services, and Health Information Management

• Oversaw the review process for RN documentation for patient charges

• Managed OR statistical reports including procedures and worked with various types of minutes,

performance metrics, on time starts, supply costs, and medical billing software

• Managed charge rejections, BAR and patient trained in ICD-10, CPT account access procedures,

mapping procedures, cost coding, and HCPCS comparisons

Cancer & Hematology Centers of West Michigan

Billing Specialist

September 2016-June 2019

Grand Rapids, MI

• Managed all day to day functions related to coding, abstracting, and revenue cycle

• Oversaw all verification of national drug code (NDC) to ensure correct transfers to third party

payment systems

• Applied in depth knowledge of ICD-10 codes and CPT procedure coding to resolve denied and/or

rejected claims

• Arranged phone calls with patients to support with billing, treatment plans, and payment issues

• Performed daily revies of accounts seceivable to refile raind, apare for appeals

s, a d j u s t t h e

• Maintained and organized a high work volume due to billing BCBS, BCN, BCN advantage and

all collecting

• Tracking cancer diagnosis medication updates on the NCCN website and ensuring related internal

procedures were up to date

Planned Parenthood of Michigan Billing and Reimbursement Specialist May 2013-September 2016

Grand Rapids, MI

• Managed the collection and communication regarding all AR from insurance companies and

Medicaid

• Performed insurance eligibility, benefit verification, and pre-authorizations

• Process rejected claims by managing the correction and resubmission process to third party

p a y e r s

• Served as a resource to patients and staff with billing questions and concerns including

professional, efficient customer service embodying the mission of "Care No Matter What"

• Monitor claims from beginning to end, including finding missing information, authorization,

coding errors, and following up on delinquent billings

• Process bad debt write-offs according to departmental policy

• Maintain remittance advice records for all third party payers

Walgreens Infusion Services

Reimbursement Specialist

November 2009-September 2012

Coopersville, MI

• Oversaw the accurate submission of invoices to responsible parties, of any type, for all services

and products provided

• Managed the evaluation of payments received and application to the patient account

• Trained incoming staff members in bill collection

• Oversaw all second level appeals to payers

• Collected al outstanding AR starting on 30 days to 365 out in an efficient manner

EDUCATION

Ross College Medical Billing Certificate

Grand Rapids, MI

November 2009

University of Michigan

B.A. in General Studies

Ann Arbor, MI

August 1992

CERTIFICATIONS & LICENSES

• Certified Professional Coder through APPC,

April 2024

SKILLS

• ICD-10 Epic

• Excel

• Microsoft Office + Google Workplace

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