Summary
Overview
Work History
Education
Skills
Timeline
Generic

Shana Lyons

Corydon

Summary

Proven multitasker and organized professional, adept in data entry and customer service, significantly enhanced team productivity at Humana HGB. Skilled in fostering collaborative environments and improving operational workflows, I excel in decision-making and time management, ensuring high-quality customer relations and efficient process improvements.

Experienced with project coordination, ensuring tasks are completed on time and within scope. Utilizes strong planning and organizational skills to manage resources effectively. Track record of enhancing team collaboration and streamlining workflows to drive project success.

Overview

15
15
years of professional experience

Work History

Referrals Coordinator 2

Humana HGB
06.2021 - Current
  • Entered data, generated reports, and produced tracking documents.
  • Improved team productivity with regular communication and progress updates, fostering a collaborative work environment.
  • Enhanced operational workflows by maintaining well-organized documentation systems and updating records accurately as needed.
  • Receive referral request from Military Treatment Facilities and direct treatment
  • Add ICD-10 and CPT/HCPCS codes to each referral
  • Contact facilities requested by the Military Treatment Facilities to follow up with billing network status.
  • Excellent customer relation skills
  • Data entry into medical management system, assigning an appropriate provider, reviewing for benefits, and/or medical necessity as required or pending to a nurse or supervisor who can complete or request additional information. Recognizes a sensitive diagnoses and/or referral requiring Case Management, and pend to appropriate point of contact for review. Understands TRICARE benefits/limitations and Humana Military referral processes, MOUs with MTFs, and referral and UM policies. Answers questions or contacts MTFs and/or civilian providers to obtain additional information that may be required to complete referral etc. Requires assigning appropriate ICD10 code to referral as well as appropriate CPT Code. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

Clerk Treasurer

Town of New Middletown
01.2010 - Current
  • Minimized late payments by closely monitoring accounts receivable and following up on outstanding invoices.
  • Supported grant application efforts by providing accurate financial data as required by funding agencies.
  • Maintained organized filing systems for easy retrieval of financial documents during audits or investigations.
  • Safeguarded municipal funds through proper cash handling procedures and regular bank reconciliations.
  • Managed payroll processes for all city employees, ensuring timely and accurate disbursement of salaries.
  • Improved financial record accuracy by diligently maintaining and updating accounting records for the municipality.
  • Reconciled monthly statements, invoices and expense accounts, keeping records accurate, and current.
  • Increased flow of financial information throughout company by improving communication strategies.

Billing and Enrollment

Humana HGB
05.2020 - 06.2021
  • Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
  • Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
  • Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
  • Enrolled beneficiaries in Tricare coverage and assigned in the PSA with allowed providers
  • Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.

Medical Assistant/Billing Specialist

Kids R Great Pediatrics
10.2019 - 04.2020
  • Sanitized, restocked, and organized exam rooms and medical equipment.
  • Obtained client medical history, medication information, symptoms, and allergies.
  • Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
  • Performed medical records management, including filing, organizing and scanning documents.
  • Built strong relationships with patients through effective communication skills that foster trust in the clinic''s commitment to quality care.
  • Coordinated patient referrals to specialists or other healthcare providers as needed for comprehensive care management plans.
  • Collaborated with interdisciplinary healthcare teams to provide coordinated care.
  • Assisted with billing and coding processes, ensuring accurate insurance claims and patient invoicing.
  • Identified, researched, and resolved billing variances to maintain system accuracy and currency.

Education

Associate of Science - Medical Assistant/Medical Billing

Ivy Tech Community College of Indiana
Indianapolis, IN
06-2006

Skills

  • Multitasking and organization
  • Customer service
  • Data entry
  • Decision-making
  • Employee Loyalty
  • Strong interpersonal skills
  • Time Management

Timeline

Referrals Coordinator 2

Humana HGB
06.2021 - Current

Billing and Enrollment

Humana HGB
05.2020 - 06.2021

Medical Assistant/Billing Specialist

Kids R Great Pediatrics
10.2019 - 04.2020

Clerk Treasurer

Town of New Middletown
01.2010 - Current

Associate of Science - Medical Assistant/Medical Billing

Ivy Tech Community College of Indiana

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Shana Lyons