Carrie Lacey

• Process health insurance claim denials
• Process workers compensation claim denials
• Call patients to obtain workers compensation insurance
• Call employers to obtain workers' compensation insurance.
• Call health insurance payers to obtain claim denial information
• Submit corrected claims and medical records to insurance companies

● Determined cause of denial of claims from United Healthcare and other payers.

● Verified eligibility and/or Coordination of Benefits

● Determined of cause of health denials.

● Submitted corrected claims when needed.

● Worked with health insurance payers to determine payment of denied claim.

● Processed member CMS appeals.

● Processed CMS and Medicaid member grievances.

● Verified eligibility and benefits for members.

● Sorted and assign grievances to coordinators.

● Took incoming phone calls for all health plans.

● Corrected UB-O4 and 1500 claims for submission to carriers

● Verified workman's compensation carrier information with employers.

● Verified claims mailing addresses.

● Provided all required medical records for carriers.

● Contested claim payment amounts with workers compensation carriers.

● Processed medical liens.

● Managed client bill accounts.

● Obtained all demographic and insurance information from outpatient, ER and OB patients.

● Notified insurance companies of patients’ arrival at the hospital.

● Took phone calls from patients, staff and outside of the facility.

● Supported clinical staff.

● Assisted the help desk with answering phone calls and fixing their issue or assigning issue to person who was responsible.

● Responsible for billing corrections for the entire hospital.

● Assistant to the chief information officer.

● Responsible for organization of several different projects.

● Assistant producer in the health benefit department.

● Responsible for quoting and managing all life and health insurance accounts.

● Responsible for writing and managing all individual health insurance accounts.

● Responsible for bank deposits.

● Relief for the receptionist.