Lora Roach

Worked daily from the Centricity ETM work queue, organizing aging tabs by dollar amount. Contacted insurance carriers for appeals and reprocessing, submitted corrected claims, and followed up. Updated and verified insurance coverage, registration, and processed authorizations for Radiation Therapy.

Maintained the fitting room area, ensuring it was straightened and organized. Operated the cashier station, including closing procedures and depositing funds at the end of shifts. Assisted customers in finding appropriate clothing and navigating the store, providing excellent customer service.

Researched, reviewed, and updated insurance verification for daily schedules and authorized upcoming surgeries and diagnostic testing. Processed daily A/R and Refunds reports, reviewed/requested daily adjustments, and collected surgery deposits. Handled Medicare/Medicaid processing and eligibility review, requested referrals, and processed incoming mail and clerical duties.

Researched and processed insurance claims for the Appeals process, working daily Epic A/R workqueues. Processed patient and insurance refunds and worked daily refund reports. Obtained authorizations for upcoming appointments and verified patient insurance coverage using a real-time system.

Verified and obtained authorizations for upcoming appointments, faxing authorizations for insurance carrier approvals. Verified patient insurance coverage, co-pay, and deductible amounts before appointments. Assisted with special projects and other daily clerical duties.

Researched and processed unpaid insurance and medical claims, updating patient and current insurance information. Worked daily refunds reports and processed insurance and patient refunds. Processed daily commercial insurance, monthly A/R collections, and Midland reports, posting daily collections and personal payments.

Followed up on unpaid and problem claims, processing claims and collection reports. Researched EOBs and medical records through the HIM system. Processed Medicare and Missouri Medicaid claims, handled delinquent accounts, and answered questions from patients and insurance companies.

Responsible for answering calls from patients and insurance companies. Posted payments and refunds to patient accounts. Updated address changes and insurance information, processed claims to insurance carriers, and requested/researched EOBs and medical records.

Responsible for updating CPT/HCFA codes and address changes. Processed and filed clean claims. Performed other clerical duties as required.

Served as a Process Representative II. Actively participated in the Volunteer committee. Recognized with the Team Player award.

Completed coursework focused on data processing techniques and principles. Earned a Certificate in Data Processing upon graduation in 1991.

Completed secondary education curriculum. Graduated from the International Studies Magnet program in 1988.