Lisamae Brown Email & Phone Number

Charlotte, Nc, Us

Remote

Assessing and providing human feedback on AI-generated information or writing for ML models based on standards of writing quality including brevity, writing style, grammar, factuality, and natural language processing (NLP).Evaluating AI writing prompts, parameters, API input, and API output, and researching or fact-checking data to inform the enhanced performance of AI models and chatbots.Analyzing AI responses, NLU, and NLG using established rubrics, expert knowledge, and research to facilitate improvement of ML model performance. Reviewing the evaluations of other team generalists and providing original, written justifications to support evaluations.Reviewing project guidelines and training materials and completing assessments during onboarding for projects.*AI-generated data on Outlier.ai helps the world’s most innovative companies improve their AI models by providing human feedback.

North Carolina, United States

Technical knowledge of HIPAA transactions: 837, 270/271, 277CA, 999, 834, 835.Researching and troubleshooting for root cause of failed EDI transactions, missing 835 files, and abends internally and with major clearinghouses including Office Ally, Change Healthcare, Availity, Redcard/Zellis, Optum, and SDATA. ERA or 835 enrollment for manual commercial, Medicaid, and Medicare payers to reduce FTE impact- employees required to post payments manually from paper remittances. Researched and provided payer data from 835 file raw data to departments responsible for issuing refunds to payers.Collaborated with e-commerce and data mapping department to resolve EDI delays with monthly unreconciled inventory averaging $350,000.Maintained and organized multiple databases in MS Access and Excel to track missing files and revenue.Processed monthly invoices for payer-facilitated EDI services. Tracked invoice process in Microsoft Excel for ad hoc reporting to management. Troubleshoot EDI issues with high-dollar State Medicaid payers and clearinghouses, contacting Medicare contractors regarding missing 835 files and resolving data transmission issues with Provider relations and electronic remittance operations teams.

New York, United States

Spearheaded fee-for-service, capitation billing, and accounts receivable for over 10 providers with weekly surgical caseloads exceeding 20 patients. Optimized revenue cycle processes, ensuring accurate payment reconciliation, timely filing, and accounts follow-up for all claims. Expert utilization of clearinghouse integration and practice management software to manage A/R.Coordinated claims processing - scrubbing, batching, and electronic submission of all claims and printing claims to UB04 and HCFA forms as required for manual submission. Coordinated coverage and benefit verifications and referral requests for patient encounters.Streamlined patient collections for self-pay and balance billing, prepared and mailed monthly statements.Troubleshooting and resolution of insurance overpayment disputes and OMIG HMS Recovery requests, claim audit medical record requests. Researched and prepared appeals, claim reconsiderations, and payment disputes for submission to payers.Expert knowledge of Medicare NCDs, LCDs, and PTP NCCI edits, insurance clinical coverage policies, CARC and RARC codes, and authorization guidelines. Created appeal letter templates and training tools for prospective new staff and provided training. Extensive experience with APG payment rates, Medicare facility fee schedules for ambulatory surgery centers as well as non-facility fees for professional office claims. Audited operative reports and office progress notes to evaluate coding accuracy, charge entry, and coding of outpatient surgical claims. clinical policies, and documentation requirements

Brooklyn, New York, United States

A/R follow-up, appeals, patient billing, and collections for a range of specialties including anesthesiology.Collaborated with third-party- commercial and no-fault carriers to resolve claim denials.Maximized accounts receivable functionality by monitoring and following up on appeals, collection accounts, and worker’s compensation claims.

Bronx, New York, United States

Billing and Accounts Follow-up for a range of insurance carriers including, commercial carriers, Medicare and Medicaid.Monitored open encounters, routing required coding and documentation errors to providersPerformed electronic billing with GE Centricity Practice Management software. Insurance verification and setup. Payment posting, A/R dutiesClaims submission and appeals for all sites St. Ann’s Clinic, Vanguard Clinic, and Melrose Clinic

Mount Vernon, New York, United States

Managed medical claims billing and appeals for a range of medical specialties including ; adult/internal medicine, pediatrics, obstetrics and gynecology, dentistry, ophthalmology, audiology, nephrology, podiatry, orthopedic surgery, radiology, dermatology, nutrition therapy, social work, psychology and psychiatryAccounts Receivable – accurate payment posting via manual posting as well as via ERA- electronic remittance advice application within the practice management software -Vitera- Sage Intergy to reconcile patient accounts

Albany, New York, United States

Managed patient accounts for primary care, medical specialty, and dental clinics staffed by over 100 medical providers at three treatment sites. Assisted with patient enrollment, registration, and scheduling.Credentialing assistant for special education staff in Langan School as well as for primary care and specialty clinic providers. Utilized OMIG, OIG, and NYSED websites to verify provider exclusions for all specialties and monitor provider certification.Project management for the Article 16 Rehabilitation Program and behavioral health services. Obtained insurance referrals and coordinated enrollment documentation for recreational therapies including hippotherapy, music therapy, and aquatic therapy.

Bachelor Of Arts - Ba, English Language And Literature, General, 4.0 Gpa

Activities and Societies: Alpha Sigma Lambda Honor Society (Accepted January 2024) Dean's List - 4 Semesters - Fall 2022, Spring 2023.

Journalism, Journalism