Lee Washington Email & Phone Number

Baltimore, Maryland, United States

• Provide telephonic intake to understand the medical needs of each client
• Obtain, sort, and upload medical records
• Working closely with our advisory and physician teams to ensure the client is supported through their health challenges

• Edits all healthcare claims for accurate submission according to local and federal regulations
• Meets individual quality and quantity performance goals and expectations
• Assists the department in meeting performance goals
• Imports, edits, corrects and transmits claims to third party payers on a daily basis
• Prepares daily claims submission tracking and error reports
• Assists in implementing billing system upgrades

• Screen callers requesting treatment for behavioral health needs, strengths and coping skills.
• Connect callers with appropriate levels of care.
• Facilitate caller treatment appointments and perform follow up to ensure connection.
• Provide information and resources to callers based on identified needs

• Processed and adjudicated MD Medicaid Claims.
• Analyzed and researched claims with the correct revenue and ICD-10 codes,
• Claims processing based on agreements, involving the use of established payment methods
• Processed professional (CMS-1500) and (UB-04) claim types.
• Maintained quality and productivity standards.
• Used the fee schedule to further examine claims

• Utilize the MMIS systems to verify coverage of recipients.
• Answered inbound calls
• Troubleshoot problems with Medical Assistance enrollment including identifying reasons for MA inactivation or problems completing enrollment
• Enter medical assistance case information required in the program database according to program practice guidelines
• Coordinate and track enrollment in Medical Assistance enrollment by working with
• Enrolled Consumer in MD Medicaid

Medical Insurance Coding Specialist/Coder

Certified Professional Coder

Bachelors, Health Information/Medical Records Administration/Administrator