Keri Lindley
Goodlettsville,TN
Summary
Consummate Claims Associate knowledgeable in Commerical and State Funded insurance coverage, policy terms and conditions. Facilitates claims processing by cultivating productive relationships with stakeholders. Blends analytical and administrative acumen throughout investigations and recommendations.
Overview
19
19
years of professional experience
Work History
Insurance Claims Specialist
Landmark Recovery
Franklin, TN
06.2021 - 09.2022
- Complete revenue cycle, adjust claims, research and re-bill claims, call insurance companies to gain knowledge on status, appeals, disputes
- Portal access to work within claim, clearinghouse maintenance and payments posting
- Sunwave, Waystar, Collaborate, KIPU software utilized
- Medicare and Medicaid billing and collections as well as commercial payers.
- Evaluated and settled complex insurance claims in strict timeframes.
Claims Analyst I
HFRI, LLC
Nashville, TN
08.2020 - 12.2020
- Analyze medical claims for reimbursement
- Timely filing
- Direct patient contact
- Contact commercial insurance companies directly
- Knowledge of Medicare
- Reporting and data entry
- Claims Adjudication processes.
- Identified key areas not performing well and implemented effective, new processes.
- Viewed reports regularly to make sure processing was conducted efficiently.
Insurance Collector
Premiere Credit Of North America
Nashville, TN
03.2020 - 07.2020
- Investigate hospital patient billing for errors and collection efforts, phone/internet contact with medical insurance companies to research patient balances owed to hospital, contacting patients to resolve billing/collection efforts, file claims, research claims, electronic medical records, billing software, clearinghouse investigations, account documentation
- Performed Claims adjudication processes.
- Processed debtor payments and updated accounts to reflect new balance.
- Entered client details and notes into system for interdepartmental access and review.
Office Administrator
Hanger Clinic
Nashville, TN
12.2018 - 08.2019
- Check In/Out of patients; Verify Insurance for all patients/Prosthetic/Diabetic; Collect Prescription/Medical records for Diabetic shoes/supplies and verify eligibility
- Run reports, scheduling and assigning Prosthetic patients
- Volunteer w/Mental Health Co-Op assisting patients with ADL needs.
Migration Specialist
Medical Technology Solutions of America
Hermitage, TN
06.2017 - 01.2019
- Migrate Patient EMR via various systems, Maintain HIPAA Compliance, Utilizing e Cw, HCA Citrix, PSG
- Citrix, Visual Vault, and Athena EMR systems.
- Offered troubleshooting assistance to junior personnel during project jobs.
- Coordinated data migration activities for ongoing projects to confirm alignment of progress with prescribed timelines and execution milestones.
- Created data mapping documentation for use in migration efforts.
Medical Billing
Coding Internship, Castle Dental
01.2012 - 01.2013
- Check Patients In/Out, Maintain patient files, Schedule/Confirm appointments, Verify insurance coverage,Billing and Coding of accounts for procedures, Insurance Collections, Answer phones.
Human Resources Director/Billing & Coding Trainer
Northwest Dialysis/Sohum Renal Group of Texas, LLC
01.2008 - 01.2011
- Recruit, Interview, and process new employee's, credentialing, Maintain employee files, Assure compliance with State and Federal mandates, Payroll, Insurance enrollments, Train Billing & Coding/
- Insurance Collections, TPAT facility Advocate.
- Handled on-boarding process for newly hired employees and distributed all paperwork.
- Provided immediate updates to entire employee pool when policies and procedures were altered.
- Developed incentive program for hiring of and retaining of employees.
- Created and implemented forward-thinking initiatives to improve employee engagement.
NLCSS/Data Entry/Office Manager
Bethany Home Health Services, Inc
01.2005 - 01.2008
- Maintain patient files, Physician communication, Intake of new patients, Data entry of OASIS & 485 information, Ordering of office/clinical supplies, Recruit/Maintain clinical staff files and credentialing,
- Assist Clinical staff with patient information & charting, Answer phones, Scheduling of patient visits & assessments, payroll
- Insurance Follow up/Collections/Timely filing.
Assistant Office Manager/Billing
Norman Goldman, DPM
01.2002 - 01.2005
- Kept front office clean and well-organized to keep areas presentable for guests and maximize professional appeal.
- Recorded expenses and maintained accounting records.
- Created and updated physical records and digital files to maintain current, accurate and compliant documentation.
- Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving.
- Check Patients In/Out, Scheduling, Billing & Coding of patient charges,
- Insurance Follow Up/Collections/Timely Filing
- Accounts Receivable, Accounts Payable, Maintain Millbrook
- Medical Mgmt
- EMR system.
- Greeted guests in with friendliness and professionalism.
- Worked closely with manager to provide effective assistance for specific aspects of business operation.
- Answered incoming calls, processed requests and relayed messages to appropriate personnel.
- Assisted manager in all aspects of business operations.
- Managed and completed paperwork and overall office administration operations.
Office Manager
Transtar Industries, Inc
01.1998 - 01.2003
- Credit & Collections, Accounts Receivable, Accounts Payable, Billing, Human Resources, Payroll, AS400 system management, Customer Service.
Education
BBA - Business
Tennessee State University
Nashville, TN2016
Associate of Applied Science - Medical Billing & Coding
Daymar College
Nashville, TN07.2013
High school diploma -
Yellville-Summit High School
Yellville, AR05.1994
Skills
- Citrix/EPIC/AllScripts
- HIPAA
- ICD - 9 and ICD-10
- CPT Coding
- Medical Collection
- Auditing
- Contract Negotiation and management
- Root cause analysis
- Sunwave/Collaborate/KIPU/WayStar
- Substance Abuse Recovery
- Claims Appeals/Disputes
- Claims Handling/Investigations
- Policy & Procedure Preparations
- Billing/Charge Coding
- EHR/EMR Program Utilization
- Accounts Receivable/Payable
- Recruitment/Human Resources/Payroll
Timeline
Insurance Claims Specialist
Landmark Recovery
06.2021 - 09.2022
Claims Analyst I
HFRI, LLC
08.2020 - 12.2020
Insurance Collector
Premiere Credit Of North America
03.2020 - 07.2020
Office Administrator
Hanger Clinic
12.2018 - 08.2019
Migration Specialist
Medical Technology Solutions of America
06.2017 - 01.2019
Medical Billing
Coding Internship, Castle Dental
01.2012 - 01.2013
Human Resources Director/Billing & Coding Trainer
Northwest Dialysis/Sohum Renal Group of Texas, LLC
01.2008 - 01.2011
NLCSS/Data Entry/Office Manager
Bethany Home Health Services, Inc
01.2005 - 01.2008
Assistant Office Manager/Billing
Norman Goldman, DPM
01.2002 - 01.2005
Office Manager
Transtar Industries, Inc
01.1998 - 01.2003
BBA - Business
Tennessee State University
Associate of Applied Science - Medical Billing & Coding
Daymar College
High school diploma -
Yellville-Summit High School
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