Lesley Stapleton Email & Phone Number

United States

Grievances and Claim Adjustments Claims processing

Austin, Texas, United States

Accounts receivable Filing Vision claimsCustomer service Check out and Front desk

Austin, Texas Area

• Reviews and interprets explanation of benefits (EOB) from insurance carriers to post appropriate payment and denial codes
• Completes tasks accurately while maintaining quality and production standards
• Enters alphabetic, numeric, or symbolic data such as denial codes and rejections from all payers into practice management system
• Posts payments and adjustments from patient statements, remittance advices, insurance carriers, and electronic downloads while utilizing the appropriate fee schedule/policy
• Meets monthly close deadlines

Dripping Springs, Texas

*Responsible for submitting HCFA claims to insurance companies and payers such as Medicare. *Research claims that have been rejected or denied and contact the payers to resolve any issues that there may be.

Austin, Texas

Processes claims that are not auto adjudicated meeting production and quality expectations. Applies deductibles, co-pays, co-insurance maximums and determines provider and member reimbursements. Assigns appropriate benefit codes necessary to process claims.Examines claims for eligibility, accident details, and other issues.Researches claims issues.

Austin, Texas

Audit check run and send claims to the claims department for corrections Identify any system changes and work notify the Plan CIA Manager to ensure its implementationCollabroate with the claims department to price pended claims correctly Document, track and resolve all plan providers' claims projectsCollaborate with various business units to resolve claims.

Austin, Texas

Processes claims that are not auto adjudicated meeting production and quality expectations. Applies deductibles, co-pays, co-insurance maximums and determines provider and member reimbursements. Assigns appropriate charge types necessary to process claims.Examines claims for eligibility, accident details, and other issues.Researches claims issues.

Assisting with training new hires. Being available to answer questions regarding claims processing. Reviewing quality audits to ensure claims are processed correctly.Assisting the Supervisor with any additional duties needed.

Processing Veterans medical claims

Austin, Texas Area

Auditing commercial and self-funded groups to ensure compliance when transitioning from Amysis system to Health Edge system.

Austin, Texas Area

Daily responsibilities included auditing self-funded groups and commercial groups at renewal time for compliance with the schedule of benefits and contracts.

Austin, Texas Area

Responsible for reviewing and analysis of all institutional claims for HMO, PPO, CHIP, Medicare and Medicaid products.Responsible for entry of physician and institutional claimsAuditing commercial and self-funded groups to ensure compliance when transitioning from Amysis system to Health Edge system.