Lisel Laslie Email & Phone Number

Tallahassee, Florida Area

Bureau Chief for the Data Quality and Collection Bureau in the Division of Workers Compensation.

Tallahassee, Florida Area

Data Management Section Supervisor, Contract Manager, training, support services, IT management.

Review contractual services with managed care, medical bill review re-pricing, and claims services to insure that claims related aspects of the contracts are properly administered. Make recommendations regarding solutions to problems of non-compliance. Educate staffMonitor IS and methods of data entry and storage. Make recommendations for modifications. Review changes in the workers’ comp laws, rules and policies and make recommendations to insure compliance. Write policies & procedures. Conduct queries, and research to collect data and information for analysis of data elements and quality. Make recommendations to solve problems improve operational/managerial practices and reduce claim costs. Provide educational and consultative services to state agencies regarding the workers’ comp program. Perform special projects or administrative tasks.Review legislative changes, Division of Workers’ Compensation rules and court decisions to analyze the impact on the bureau’s program.

Conducted claims investigations of workers’ compensation claims submitted on state employees, applied appropriate laws and made determination of compensability. Evaluated medical reports, authorized treatment, authorized compensation payments and settlements. Calculated and maintained proper monetary reserves on claims. Trained and supervised the activities of a Senior Workers’ Compensation Examiner. Supervised claims that were assigned to defense counsel by directing defense activity to conform to sound claims handling. Attended formal mediations and hearings when necessary. Assisted and advised Claims Coordinators from various state agencies, departments, divisions, bureaus and sections with questions concerning workers’ compensation claims, including but not limited to; coverage, compensability, treatment and reporting work related accidents. Supervised the activities of Risk Management’s prior service companies.

Examined medical bills to ensure all information was correct, reviewed codes for accuracy, refer bills to MCO or Financial Section for payment after approved. Assisted the Workers’ Comp Specialist in handling claims, reviewed first report of injury forms and edited information on the AS400 and imaging systems. Retrieved batches from the First Report of Injury Que and Workflow, indexed documents, and indexed faxes from the fax queues. Answered questions and addressed problems regarding workers compensation, timely mailed information to employees, returned calls promptly. Processed in-house bills in accordance with the Bureau’s Policy and Procedures.

Maintained all client records, worked in conjunction with the central billing office to ensure claims were filed correctly and in a timely manner, ordered supplies, performed HR duties, accounts payable management, payroll and all other general office functions. Assisted the marketing/community nurse with projects within the community to obtain recognition for the company and market our services.

Reconciled multi-million dollar accounts on a daily basis, researched discrepancies, worked in Excel, Access and Word and company's proprietary software. Performed month end reconciliation of accounts and submitted reporting to supervisor for checks/balances. Other duties as assigned

Supervised staff of 10-12 employees within the insurance billing and reimbursement areas. Prepared deposits for the bank on a daily basis, worked closely with the Patient Accounting Department, Asst. Controller and Controller on adjustments, accruals, Medicare and Medicaid issues and end of month balancing and reconciliation. Also performed PBX operator duties from 09/01/2000-10/01/2005.

Worked in conjunction with local area AHCA office to train providers on how to correctly file claims with Medicaid. Installed billing software and trained providers on how to use. Averaged more than 400 contacts per month within the 3 county area that I served. Increased reimbursement time for some providers from 45 days to 7 days.

Supervised call center team of approx 60 employees in conjunction with 2 other supervisors. Worked with manager to implement training program, new phone system. Worked with adjudications and banking to resolve past due claims totaling over $3 million.

Admissions interviewer;PBX Operator,Scheduling Clerk; Registered patients into the hospital for admission/out-patient tests. Collected payments & insurance information.Answered calls to the central switchboard.Scheduled/pre-admitted patients for in and outpatient procedures.Finance Counselor; Reviewed 350+ accounts weekly for appropriate insurance payment,secured information through telephone calls to carriers,patients,nursing home,attorneys,physicians offices and other medical facilities;submitted corrective billing;worked third party correspondence regarding denied or pending claims,submitted explanation of benefits to secondary payers.Successfully secured insurance reimbursement on accounts with balances in excess of $100,000.00 Admissions Coordinator Supervised staff of 25-30 employees in the Admissions Office/ Emergency Room Admitting.Training Coordinator Interviewed and hired staff. Wrote departmental procedures and developed a training program for new employees.

Ba, Insurance/Risk Management

Education record

Aa, Nursing Science

Education record

Education record