LISA L DAVIS8001 W Beckett Ave, Milwaukee, WI 53218 | C: 414-213-8083 | lisjan5@yahoo.com

www.linkedin.com/in/LisaDavis015

Professional Summary

Customer focused health insurance professional with over 14 years experience resolving customer inquiries and appeals. Knowledge of medical office procedures and understanding of commercial and private insurance carriers laws and regulations. Familiar with ICD-9-CM, ICD-10-CM an ASC coding. Skilled in medical terminology, excellent customer service and communication skills. I am a flexible and responsible individual who is eager to learn in new ways and who strives for excellence.

Skill Highlights• Maintains strict confidentiality• ICD-9 coding

• Trained in ASC Coding

• CPT and HCPCS coding

• Interpreting instruction

• HIPAA compliance

• Patient-focused care

• Strong work ethic

• Team player with positive attitude

• Deadline-driven

• Good Written Communication

• Exercises good judgment

• Virtual office

Professional Experience

Physician Coding Liaison-10/2016 to PresentAurora Health Care- West Allis

• Provide onsite coding and documentation education and feedback to assigned providers for coding changes (CPT including E&M, modifiers and internal codes, ICD-9, ICD-10, HCPCS), annual updates, payor requirements and insurance rejection resolution.

• Orientates all providers, residents/students and clinical caregivers on documentation and coding matters.

• Coordinates responses to provider questions along with Compliance and Clinical Informatics team members.

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• Attends and provides data as requested to provider/clinical caregiver/clinic department meetings.

• Attends provider meetings that may include coding or documentation issues, such as Medisync and ICD-10 training.

• Reviews and provides guidance on order entry, diagnosis and charge capture preference lists as well as SmartSets and templates for coding and documentation specific items.

• Monitors assigned missing documentation and other transfer Epic work queues to urge and ensure providers are completing work to ensure proper support for billing.

• Maintains current knowledge of Medicare, Medicaid and other regulatory requirements pertaining to nationally accepted coding policies and standards.

Customer Resolution Specialist-03/2005 to CurrentAssurant Health － Milwaukee, WI

• Conduct quick, thorough analysis of correspondence to understand what the customer is requesting and identify any cues or personal preferences that need to be accommodated.

• Investigate all aspects of the customer’s issue(s) at hand by using mainframe systems, departmental guidelines and compliance information in conjunction with the customer’s insurance plan and any specific state mandates.

• Conduct a complete and final resolution of cases within a specified deadline while explaining technical insurance concepts in an easy to understand format.

• Utilize problem-solving techniques and probing questions and apply product knowledge and theory.

• Work independently to diffuse situations to mitigate escalations.• Responsible for weighing all factors associated with a case and making informed, accurate

determinations and make high-stake decisions independently.• Respond in writing to customers regarding determinations with accuracy, clarification,

discretion and adherence to technical and departmental guidelines while taking in consideration the customer’s emotions so they feel respected.

• Service as a peer-to-peer mentor, coach and reference guide for the CRS role.

• Provide market and customer related information, trends and risks. • Assist with special projects.

Individual Medical-Identification of Benefits & Claims Representative-07/2003 to 03/2005Assurant Health － Milwaukee, WI

• Received inbound calls from agents, policyholders and physician offices to assist in identifying potential benefits on diagnosis and procedure coding.

• Answered questions and resolved issues regarding processed, pending and data captured claims.

• Audit claims for accuracy.

• Complete administrative functions such as documentation, research, customer referrals and follow-up.

• Review State Mandates, State Compliance Grids, Product Form Numbers and On-line Resources to determine if a benefit are available.

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• Exceed department standards for call handling with average handle time of 260 seconds and quality percentage of 100%.

Small Group Administration Team Captain/Customer Service Representative-06/2002-07/2003Assurant Health － Milwaukee, WI

• Received inbound calls from agents, policyholders and physician offices to assist in identifying potential benefits on diagnosis and procedure coding.

• Audit claims for accuracy.

• Complete administration functions such as documentation, research, customer referrals and follow-up.

• Review State Mandates, State Compliance Grids, Product Form Numbers and On-line Resources to determine if a benefit are available.

• Educate customers in order to help them understand the product they have purchased and how to maximize available benefits.

• Acted as backup to the Supervisor. Delegated work to staff to ensure service availability and compliance.

• Exceed department standards for call handling with average handle time of 290 and quality percentage of 100%.

Education and Training

Certified Coding Associate (CCA)2016-Ahima

Bachelor of Science: Health Information ManagementHerzing College － Madison, WICurrently studying BA-Health Information Management

Associate of Applied Science: Applied Science & HealthcareHerzing College － Madison, WIApplied Science & Healthcare-degree -Certified Coding Specialists

Medical Billing and Insurance CodingHerzing College － Milwaukee, WIGPA: Madison, WI *Honors Student, Cum Laude GPA: 3.69 Spring Semester2006-Academic Dean's List GPA: 3.5

1997 High School Diploma: General Studies/Keyboarding

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Harold S. Vincent High School － Milwaukee, WI

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